The most important lesson from 83,000 brain scans | Daniel Amen | TEDxOrangeCoast

The most important lesson from 83,000 brain scans | Daniel Amen | TEDxOrangeCoast


Translator: Ilze Garda
Reviewer: Denise RQ In this talk, I’m going to give you
the single most important lesson my colleagues and I have learned
from looking at 83,000 brain scans. But first, let me put
the lesson into context. I am in the middle of seven children. Growing up, my father called me a maverick which to him was not a good thing. (Laughter) In 1972, the army called my number, and I was trained as an infantry medic
where my love of medicine was born. But since I truly hated the idea
of being shot at or sleeping in the mud, I got myself retrained
as an X-ray technician and developed a passion
for medical imaging. As our professors used to say:
“How do you know, unless you look?” In 1979, when I was
a second-year medical student, someone in my family
became seriously suicidal, and I took her to see
a wonderful psychiatrist. Over time, I realized
if he helped her, which he did, it would not only save her life, but it would also help her children
and even her future grandchildren, as they would be shaped by someone
who is happier and more stable. I fell in love with psychiatry because I realized it had the potential
to change generations of people. In 1991, I went to my first lecture
on brain SPECT imaging. SPECT is a nuclear medicine study
that looks at the blood flow and activity, it looks at how your brain works. SPECT was presented
as a tool to help psychiatrists get more information
to help their patients. In that one lecture,
my two professional loves, medical imaging and psychiatry, came together, and quite honestly,
revolutionized my life. Over the next 22 years,
my colleagues and I would build the world’s largest database
of brain scans related to behavior on patients from 93 countries. SPECT basically tells us
three things about the brain: good activity, too little, or too much. Here’s a set of healthy SPECT scans. The image on the left shows
the outside surface of the brain, and a healthy scan shows full,
even, symmetrical activity. The color is not important,
it’s the shape that matters. In the image on the right,
red equals the areas of high activity, and in a healthy brain, they’re typically
in the back part of the brain. Here’s a healthy scan compared
to someone who had two strokes. You can see the holes of activity. Here’s what Alzheimer’s looks like, where the back half
of the brain is deteriorating. Did you know that Alzheimer’s disease
actually starts in the brain 30 to 50 years before
you have any symptoms? Here’s a scan
of a traumatic brain injury. Your brain is soft,
and your skull is really hard. Or drug abuse. The real reason not to use drugs –
they damage your brain. Obsessive–compulsive disorder where the front part of the brain
typically works too hard, so that people cannot
turn off their thoughts. An epilepsy where we frequently
see areas of increased activity. In 1992, I went to an all-day conference
on brain SPECT imaging, it was amazing and mirrored our own early experience
using SPECT in psychiatry. But at that same meeting,
researchers started to complain loudly that clinical psychiatrists like me
should not be doing scans, that they were only for their research. Being the maverick
and having clinical experience, I thought that was a really dumb idea. (Laughter) Without imaging, psychiatrists then and even now
make diagnosis like they did in 1840, when Abraham Lincoln was depressed, by talking to people and looking
for symptom clusters. Imaging was showing us
there was a better way. Did you know that psychiatrists
are the only medical specialists that virtually never look
at the organ they treat? Think about it! Cardiologists look, neurologists look,
orthopedic doctors look, virtually every other
medical specialties look – psychiatrists guess. Before imaging, I always felt like I was throwing
darts in the dark at my patients and had hurt some of them
which horrified me. There is a reason that most psychiatric medications
have black box warnings. Give them to the wrong person,
and you can precipitate a disaster. Early on, our imaging work
taught us many important lessons, such as illnesses, like ADHD,
anxiety, depression, and addictions, are not simple or single
disorders in the brain, they all have multiple types. For example, here are two patients who have been diagnosed
with major depression, that had virtually the same symptoms,
yet radically different brains. One had really low activity in the brain,
the other one had really high activity. How would you ever know what to do
for them, unless you actually looked? Treatment needs to be tailored to individual brains,
not clusters of symptoms. Our imaging work also taught us that mild traumatic brain injury
was a major cause of psychiatric illness that ruin people’s lives, and virtually no one knew about it
because they would see psychiatrists for things like temper problems,
anxiety, depression, and insomnia, and they would never look,
so they would never know. Here’s a scan of a 15-year-old boy who felt down a flight of stairs
at the age of three. Even though he was unconscious
for only a few minutes, there was nothing mild
about the enduring effect that injury had on this boy’s life. When I met him at the age of 15,
he had just been kicked out of his third residential
treatment program for violence. He needed a brain rehabilitation program, not just more medication
thrown at him in the dark, or behavioral therapy which,
if you think about it, is really cruel. To put him on a behavioral therapy program when behavior is really an expression
of the problem, it’s not the problem. Researchers have found
that undiagnosed brain injuries are a major cause of homelessness,
drug and alcohol abuse, depression, panic attacks, ADHD, and suicide. We are in for a pending disaster with the hundreds
and thousands of soldiers coming back from Iraq and Afganistan, and virtually no one is looking
at the function of their brain. As we continued our work with SPECT, the criticism grew louder,
but so did the lessons. Judges and defense attorneys sought
our help to understand criminal behavior. Today, we have scanned
over 500 convicted felons including 90 murderers. Our work taught us
that people who do bad things often have troubled brains. That was not a surprise. But what did surprise us was that many of these brains
could be rehabilitated. So here’s a radical idea. What if we evaluated
and treated troubled brains rather than simply warehousing them
in toxic, stressful environments? In my experience, we could save
tremendous amounts of money by making these people more functional, so when they left prison, they could work, support their families and pay taxes. Dostoyevsky once said:
“A society should be judged not by how well it treats
its outstanding citizens, but by how it treats its criminals.” Instead of just crime and punishment, we should be thinking
about crime evaluation and treatment. (Applause) So after 22 years and 83,000 scans, the single most important lesson
my colleagues and I have learned is that you can literally
change people’s brains. And when you do, you change their life. You are not stuck with the brain you have, you can make it better,
and we can prove it. My colleagues and I performed
the first and largest study on active and retired NFL players, showing high levels of damage
in these players at the time when the NFL said they didn’t know if playing football caused
long-term brain damage. The fact was they didn’t want to know. That was not a surprise. I think, if you get the most thoughtful
9-year-olds together, and you talk about the brain is soft,
about the consistency of soft butter, it’s housed in a really hard skull
that has many sharp, bony ridges, you know, 28 out of 30
nine-year-olds would go: “Probably a bad idea for your life.” (Laughter) But what really got us excited
was the second part of the study where we put players
on a brain-smart program and demonstrated
that 80% of them could improve in the areas of blood flow,
memory, and mood, that you are not stuck
with the brain you have, you can make it better
on a brain-smart program. How exciting is that? I am so excited. Reversing brain damage
is a very exciting new frontier, but the implications
are really much wider. Here is this scan
of a teenage girl who has ADHD, who was cutting herself, failing
in school, and fighting with her parents. When we improved her brain, she went from D’s and F’s to A’s and B’s, and was much more emotionally stable. Here is the scan of Nancy. Nancy had been diagnosed with dementia, and her doctor told her husband
that he should find a home for her because within a year,
she would not know his name. But on an intensive,
brain-rehabilitation program, Nancy’s brain was better,
as was her memory, and four years later,
Nancy still knows her husband’s name. Or my favorite story
to illustrate this point: Andrew, a 9-year-old boy who attacked
a little girl on the baseball field for no particular reason, and at the time,
was drawing pictures of himself hanging from a tree
and shooting other children. Andrew was Columbine, Aurora, and Sandy Hook waiting to happen. Most psychiatrists
would have medicated Andrew, as they did Eric Harris
and the other mass shooters before they committed their awful crimes, but SPECT imaging taught me
that I had to look at his brain and not throw darts in the dark at him
to understand what he needed. His SPECT scan showed
a cyst, the size of a golf ball, occupying the space
of his left temple lobe. No amount of medication or therapy
would have helped Andrew. When the cyst was removed, his behavior completely
went back to normal, and he became the sweet, loving boy
he always wanted to be. Now 18 years later,
Andrew, who is my nephew, owns his own home,
is employed and pays taxes. (Laughter) Because someone bothered
to look at his brain, he has been a better son, and will be a better husband,
father, and grandfather. When you have the privilege
of changing someone’s brain, you not only change his or her life but you have the opportunity
to change generations to come. I’m Dr. Daniel Amen. Thank you. (Applause)

100 comments

  1. Hope this helps anyone in need. Prayer seems to almost always help me, especially when praying for those I don't want to pray for.

    "Love your enemies, bless them that curse you, do good to them that hate you, and pray for them which despitefully use you, and persecute you" said Jesus.

  2. BUT – you have to have access to a psychiatrist. I’m a professional with a good career and health benefits and being treated by a psychiatrist is not that accessible to me, never mind someone who is homeless or can’t afford it. Mental healthcare needs to change and become accessible to every day people, but I despair that politicians will ever allow that to happen.

  3. What an amazing speaker
    Truly coming from a place where society can evolve from
    Love not hate we can never move forward with this way of thinking
    I wish that this man would do the brain scan of Nicholas Cruz

  4. "the implications are really much wider"
    So if we can bring a brain back from the edge then we can take it there as well.
    Or am I just being paranoid and need to get a scan to fix it?

  5. This is the best TED talk I ever saw. Screw the left agendas, and look at the truly meaningful things! I would say we need a yearly brain scan for every person.

  6. his is my 8 minute inspirational video about a positive treatment to heal mental health called D.T.M.S! This show also gives some inspiration on friendship and the positive affects of giving hugs!

  7. Could you imagine if this your dad?! Such wisdom can't even find words to express his expertise his thirst to learn goes on infinitely. Would love to enjoy life with someone like that.

  8. Officials at major psychiatric and neuroscience associations and research centers say his SPECT claims are no more than myth and poppycock, buffaloing an unsuspecting public.

    None of the nation’s most prestigious medical organizations in the field — including the APA, the National Institute of Mental Health, the American College of Radiology, the Society of Nuclear Medicine and Molecular Imaging and the National Alliance on Mental Illness — validates his claims.

  9. Im all caught up in this issue. The winners are the pharmaceutical giants.
    It amazing to hear Psychiatrists never look at the Organ.

  10. I suffered a bad TBI in a motorcycle accident 7 years ago, and I can 100% vouch for being different and having difficulty in life. My mood has changed, I'm much angrier than I used to be, and I don't have as much excitement about life. Anyone know how to find these brain rehab treatments?

  11. My psychiatrist has been throwing darts in the dark at me. No medical tests of any kind ever. 15 minutes to summarize a plethora of thought and emotion every two months. Time to see a neuropsychiatrist.

  12. i want to know more of the criticisms… he's right seems like something 9yo's could think of, can't be as simple as that.,

  13. i think my mental illness comes from poor posture. i'm serious. our shoulders hunch and our heads hang low. i put together the pieces. i think schizophrenia comes from a disrupted connection where the brain makes contact with the body. like when people sleep. um hallucinations and positive symptoms. i don't know. it's a hypothesis from observations. public domain.

  14. Does anyone know more about this? Does insurance cover brain scans? Who do you have to see to get a brain scan? I’d definitely be interested in getting one just to see what’s going on, not that I have a glaring problem but for preventative measures. Any info would be great, obviously I’ll google as well.

  15. And……….how exactly do you change brains ?
    As most Humans seem to be engaged in the process of swapping their brains for those of Chimpanzees, it would be nice to know what exactly is going on.

  16. T.B.I here from a E.F.P.(IED). I like his approach. Hey VA lets do this!. People…..you need to love your injured love one. My whole family disowned me after my explosion. My mom said she didn't want to loose her beach rental. No family member came to see me…my Army fam…my real fam was there.

  17. Great talk… So true. Psychiatrists nowadays are often working like they’re back in Freud’s time. Guessing and guessing… Medicine has immensely evolved and yet we still don’t have a very good balance between abstract concepts and theory, AND concrete, testable science.

  18. This Blabber mouth found that Some of us humans actually have a functioning brain ….while others in the liberal ..so called democrat parry
    Appeared in the brain scans a nonfunctioning lump of what looks like pus with abnormal deformed tentacles and unknown deformitiites which appear as small oval shaped holes or cavities
    Within the cerebellum in both children and adults.
    A possible reaction to the dummied down educational instruction and lack of thought
    attributed to liberal brainwashing and phyobabble . .. more tests and evaluations will no doubt be required and research will have to be continued …..but at this point it has a rather
    Troubling forecast of what may come to fruition . More evaluations need to be performed at this juncture…in the very near future along with increases in the budget

    Stay tuned…….

  19. So what does this brain rehabilitation program imply. What do they actually do to the patients, specifically? Did I miss something?

  20. So it means that they are able to map active areas of the brain, but still don't understand how does brain works. Although environment shapes human behavior so it would be appropriate to investigate each and every individual environment along with brain scan. Fact that crime, jealousy, poverty, bigotry, language, etc. is not inborn things, all that is learned at environment and situations that people been exposed to.

  21. It was really great and such a smart iconoclast he is.I just wish he had explained a little how they get to change the structure and function of the brain; to what extent can prescribed drugs help?

  22. Exactly why money should be going into this form of treatment instead of building prisons . Children as young as three have been identified with lack of empathy. With positive treatment (not drugs) their attitudes improve

  23. I truly wish I would have gotten this treatment when I had my skull crushed, a TBI… Yes, I am borderline homeless

  24. Is there something that would show on the scan about bipolar and is there anything you can do for that other than mood stabilizers

  25. You found that sugars and saturated fats damage brain. Many researchers found coconut oils improves brain quality. Will you clarify?

  26. You found that sugars and saturated fats damage brain. Many researchers found coconut oils improves brain quality. Will you clarify?

  27. Blessed are the poor in spirit, for theirs is the kingdom of heaven.
    Blessed are those who mourn, for they will be comforted.
    Blessed are the meek, for they will inherit the earth. Blessed are those who hunger and thirst for righteousness, for they will be filled. Blessed are the merciful, for they will be shown mercy. Blessed are the pure in heart, for they will see God. Blessed are the peacemakers, for they will be called children of God.
    Blessed are those who are persecuted because of righteousness, for theirs is the kingdom of heaven

  28. How do I go about getting the scan of my brain done I only had state-funded insurance unfortunately I don't think it'll pay for me to see a psychiatrist mental health is not an option for me

  29. So what is the intensive brain rehabilitation program he talked about that helped the NFL players and the woman with dementia? That should be the real Ted talk…

  30. Great story – it is a wonderfull and very optimistic message – and let us hope that it becomes normal practice to look at the brain and the necessary knowledge to change the brain and as such the lives of generations

  31. Not Only The Generations of that Particular person will be changed but of people AROUND him(which he/she was going to hurt if not treated ! )

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