Ep 1193 ｜ A Balanced Approach to ADD Medication ｜ Guest： Dr. Daniel Amen
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Summary
Dr. Daniel A. Amen is one of the most well-known and respected psychiatrists in the country, and he has a novel approach to looking at brain health when it comes to ADD, ADHD, autism, depression, and anxiety. He is not anti-pharmaceutical, but holistic health, looking at the whole picture of the body, and so today he is going to break that down for us. He s also going to tell us what to look for if you or someone you love may be ADD. We ll also get to the damaging effects of weed on people s brains and our society. It s not as innocuous as you are being told.
Transcript
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Wellness Wednesday is back today with Dr. Daniel Amen. He is probably one of the best known
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psychiatrists in the country, and he has a novel approach to looking at brain health when it comes
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to ADD, ADHD, autism, depression, anxiety. And today we are going to talk about the mainstream
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view of these diagnoses versus how we can actually care for our brains in a way that helps us. He is
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not anti-pharmaceutical, but he is holistic health, looking at the whole picture of the body. And so
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today he is going to break that down for us. He is also going to tell us what to look for if you
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or someone you love may be ADD. It was an absolutely fascinating conversation. We'll also get to
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the damaging effects of weed on people's brains and our society. It is not as innocuous as you
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are being told. Just an incredible conversation you will learn so much from. I know I did. We've
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got all of this and more on today's episode of Relatable. It's brought to you by our friends
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at Good Ranchers. Go to goodranchers.com, code Allie. That's goodranchers.com, code Allie.
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Dr. Amen. Thanks so much for taking the time to join us. I know a lot of people listening and
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watching, they follow you, have for a while, but for those who may not know, can you say who you are
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and what you do? So Daniel Amen, I am a husband and a father and a grandfather to five, and I am a
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psychiatrist, but I do things very differently than my colleagues. I actually think you should look at
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the brain before you go about treating it. I have 11 clinics, and we have the world's largest database
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of brain scans related to behavior, about 260,000 scans on people from 155 countries.
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Wow. And can you tell me a little bit more about the scans? Because you mentioned that most people in
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your field do not scan the brain before they diagnose an adult or a child with ADD. So what are
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your scans and what do they set out to accomplish? So at Amen Clinics, we do a study called brain
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SPAC imaging, SPAC, single photon emission computed tomography, is a nuclear medicine study that looks
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looks at blood flow and activity, looks at how your brain works. And it tells us basically three
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things, good activity, areas with too little or areas with too much. And then our job becomes about
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balancing the brain. And why we do that when most others don't is, before I went to medical school,
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I was an x-ray technician. And our professors used to say, how do you know unless you look? And when I
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decided to be a psychiatrist, my first wife tried to kill herself when I was in medical school.
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I took her to see a wonderful psychiatrist. And I realized this is a profession that can change
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generations of people. But I joined the only medical specialty that never looks at the organ
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it treats. And I thought then it was insane. And I just had no idea that I would be part of changing
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it. And think about this with me. Why are psychiatrists the only medical doctors who never
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look at the organ they treat? And because of that, Ritalin is controversial. For the wrong brain,
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it's a nightmare. And for the right brain, it's miraculous. And how would you know ahead of time
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if you didn't actually look at the physical function of the organ you're treating?
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And, you know, SPECT is not the only way to look at the brain. Other people do PET scans. Other
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people do quantitative EEG. Other people do functional MRI. I just love SPECT. And, you know,
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because we built this database of experience, well, that's hard to replicate. And what we learned
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about ADD or ADHD, it's just a different term for the same thing. That when people who have this
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disorder try to concentrate, the front part of their brain shuts down. Where in a healthy population,
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it turns on. So what does that mean? It means the harder they try, the worse it gets. And how would I
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know that if I didn't look? How would I know a child's ADD was due to their brain working too hard
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or not hard enough? And I can't tell. Like, I'm not a magician where I can, you know, divinate you
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how your brain does this by your behavior because you can have the same symptom clusters
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Right. Okay. So it could be, are you saying that people with ADD, it could be that a part of their
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brain isn't working hard enough or that it is working too hard? Or is everyone who is displaying
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these kind of ADD symptoms, the inability to concentrate, do they all share that commonality
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of the front part of their brain just shutting down when it should be turning on?
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Not all of them. But in my book, Healing ADD, I talk about the seven different types. And
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six of the seven have that sort of deactivation. But one of the types, the type we call the ring
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of fire activates too much. And when you give them a stimulant, 80% of the time you disrupt them,
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you make them worse. And they tend to be the ones we see. We typically don't see the sort of classic
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ADD or the unattentive ADD because their pediatrician has seen them. And generally,
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like, you know, the medicine helps them. We tend to see the treatment failures. And so
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we see way more ring of fire than a typical child psychiatrist.
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So ring of fire is where their whole brain is really much more active than it compared to healthy.
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It's like the freeway is jammed. And the world comes at them too fast. They get easily distracted.
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They tend to be rigid. And if things don't go their way, they tend to be upset. And if you stimulate
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an already overactive brain, you generally make them worse. And so we do treatments, we use the scan
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sort of like a map. And you've heard it said a picture is worth a thousand words, but a map is
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worth a thousand pictures. A map tells you, okay, here's where you are and gives us direction on how
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to get to where you want to go. And so it's like the traffic in LA where it's just way too busy.
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And there are different kinds of ADD medications. Like you mentioned the stimulant. Would that be
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something like Ritalin where you're trying to stimulate a part of the brain that is shut down?
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Okay. And then there's another kind, if you're over-stimulated brain,
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you would take a different kind of medication that helps it calm down?
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Yes. I actually like a supplement that I developed, goodness, 25 years ago that has GABA. GABA is an
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inhibitory neurotransmitter, 5-HTP, which is the precursor for serotonin, and L-tyrosine,
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which is the precursor for dopamine. And that tends to have a nice calming factor.
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A balancing effect on the brain. And when I started scanning people in 1991, I came to realize
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some of the meds we prescribed were actually harmful to the brain. And then I remember in
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medical school, all medical students learn, first do no harm, use the least toxic, most effective
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treatments. And because of that, I got very interested in natural supplements, lifestyle,
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dietary interventions for the brain. So if you come to Amen Clinics, the first thing we're going to do
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is take a really good history, do cognitive testing, do imaging. And then we don't think about,
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well, what medicine would we use? It's, well, what lifestyle or natural supplement might we try
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first to see if we can't get better balance to your brain?
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But you do see a need in some cases for pharmaceuticals, because some would say no Ritalin
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and ADD medications. They always suppress the personality. They take the uniqueness out of
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the kid. And we shouldn't prescribe that at all. But it sounds like you're saying, and from what I've
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read, these can be of benefit to people with certain kinds of ADD.
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They can be miraculous, right? And I think withholding proper treatment
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from an adult or from a child is like withholding glasses from someone who can't see. Now, I've been a
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psychiatrist for 40 years. And when I prescribe a stimulant and it's the right thing for the person,
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it doesn't make them depressed. It doesn't dull their personality. It helps them be who they really
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are when their brain is healthy. Now, if you come at this with a preconceived idea that all medicine
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is of the devil, well, then you can find all sorts of cases where these medications have made people
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worse, because they all have black box warnings. Because if you give them to the wrong person,
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they're going to make people worse. But there's a whole bunch of other cases where someone went from
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C's and D's to all A's and B's and got into law school or medical school. Or I remember one of my
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early cases, I saw the son of a business person. And he's like, Dr. Amen, if you think I'm bad,
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you should see my dad. And then I saw his daughter. And she said, Dr. Amen, if you think I'm bad,
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you should see my dad. And then I saw the wife who didn't have ADD, but she was chronically stressed
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because she was married to the guy that had ADD. And she's like, you have to help me with this
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stress. And so finally, he's the fourth person in the family that came to see me. And the scan
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totally convinced him he needed to take care of his ADD. And the next year, he made three times the
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amount of money he'd ever made in his life, because he could focus. And so I think withholding
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medicine is not the right thing. But don't give everybody who has ADD the same treatment. That's
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like giving everybody who has heart disease, the same treatment, which is stupid, right? I mean,
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there's a hundred different causes of chest pain. You don't give everybody the same treatment.
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You try to go, well, what's the cause of the chest pain?
00:13:41.360
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A lot of people have a concern, specifically in young boys being diagnosed with ADD. Boys tend to
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be more rambunctious than girls at an early age, can't sit still for as long. They want to be more
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aggressive outside running around. And some people believe that because young boys don't always fit
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into the perfect, you know, kindergarten paradigm when they're five, six years old, that they're
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over-medicalized. Do you think that's true, that boys are kind of being punished for being boys told
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they have ADD at a young age when maybe they're just young boys? Yes. Sometimes it's a maturational
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delay, which is why if you have an active boy or girl, it's probably best for them to be older.
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In their class, like my birthday's in July. So I was barely five when I started kindergarten.
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Probably with what we know now, it would have been better to hold me back for a year because then I
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would have, just think about it, almost 20% more brain development. Right. I think my wife was
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actually four and a half when she started kindergarten. And what we now know, the brain needs time to
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mature. So that's often one factor. Another factor we should talk about is diet. Things like artificial
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dyes and sweeteners are rampant. They're like in 10,000 products in the United States. If you have a
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processed food diet, you're much more likely to present like you have ADD. There's this great study
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out of Holland that they actually replicated. And I think the original study was on 300 kids who had
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ADD or ADHD. They eliminated gluten, dairy, corn, soy, artificial dyes, and sweeteners. And after
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six months, 70% of them didn't have ADD anymore. Wow. And so shouldn't the first intervention
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be, let's just clean up your diet and let's take away the dopamine stealers, your gadgets,
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and get you more sun and more exercise and some simple nutrients like omega-3 fatty acids.
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And see, like to me, that's imminently rational to before you give someone a stimulant that's going
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to change their brain, let's just clean up your diet and your habits. And if after you clean up their
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diets and habits, there's still a half an hour of homework takes them four hours to do that their
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level of impulsivity is unacceptable, that they can't focus and they're not performing anywhere
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near their ability in school. Well, then let's scan them and let's consider supplements or medication.
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Something that I learned from your book is that it is a misconception that people with ADD
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cannot focus on anything, that they're always just kind of like bouncing around like a jelly bean.
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Some people with ADD can get very focused. I've seen this before. They can get hyper-focused on
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something. They may be able to sit down and read, you know, an entire book in one sitting if they're
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really interested in it. It's really that they can't concentrate on things that they don't want
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to concentrate on, whereas someone without ADD would be able to. Is that correct?
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That's correct. In fact, maybe we should talk about how do you know if you have ADD?
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And the five hallmark symptoms. And the first one is short attention span, but not for everything.
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It's short attention span for regular, routine, everyday things. Schoolwork, homework, paperwork,
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chores, chores, the things that make life work. But, and this is what surprises people for things that
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are new, novel, highly stimulating, or frightening. People with ADD can pay attention just fine.
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Things that have their own intrinsic dopamine. So, you know, adults that have this because
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they fall in love and for like four to six months, they're totally focused. But as the dopamine and
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new love wears off, they can't pay attention at all. And their partner's like, hey, where'd you go?
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Or if they're, have a new hobby, and they love it, they'll focus on it. Or they have a teacher they
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love. That one class will be great, but the six other teachers are complaining they can't focus.
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So, it's new, novel, highly stimulating, or frightening. And that's often why they like extreme sports.
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Or why they can be risk takers. Because they're looking for the thrill. It's also why they tend to be
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negative. And in Healing ADD, I talk about the games ADD people play. And the first game they play is
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let's have a problem, is they pick on other people, they like poke at them, just so that they can sort of
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get that reaction out of them. And I always tell parents, when the child hands you the rope to play
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tug of war, don't pick up the rope. And there's a great parenting section in that book. The second
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symptom is they're easily distracted. They see too much, they hear too much, they sense too much. It's
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like the world comes at them too fast. And they hate tags in clothes, because they feel them. My first
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wife had ADD, I write about that. And right after we got married, I went into our little apartment, and
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we were staying in medical school, you know, in school housing. And all of my shirts had the tags cut
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out. And I've never felt a tag in my life. And I took one of the shirts into the our little family
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room. And I'm like, do you know what happened to my shirts? She goes, you had all those tags.
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I hate tags. Don't you hate tags? Aren't you happy I did that? And I'm like, never felt a tag ever.
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Please don't cut up my clothes. Yeah. I laughed when I heard that story when I was listening to your book.
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And there's so much, and I won't interject too much. But I, there was so much as I was listening,
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I was like, wow, this reminds me of this person. This reminds me of this person. This reminds me of me.
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My grandmother lived with us growing up. And she would always, I would always have her cut the
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tags out of all my clothes. And to this day, I cannot stand tags in my clothes. I feel it all day.
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It's like the princess and the pea. And I have plenty of other things in this book that remind
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me of myself. But I, I laughed when I when I read that, because I can relate to her, the tags have
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always bothered me. Well, if you have, you know, the way we often diagnose ADD in women is they bring
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their children to us. Uh, because women often do not get diagnosed. So maybe more over diagnosed,
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over diagnosed in boys, but not in girls. It's probably under diagnosed in girls because we still
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have serious gender bias in this country. And if a little boy is having trouble, the parents get upset.
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And they're like, he's gonna have to take care of her family someday. And if a little girl is having
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trouble, they're like, Oh, maybe she's not that smart. We hope she marries somebody nice. And that's
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completely irrational. Because if anything, I just did a post of my wife and I do a podcast together
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called change your brain every day. And we were talking about energy. And we have three generations
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now tired women, because they're doing way more than taking care of the house and the kids. Uh,
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and if they have ADD, they often look depressed. When they're really not depressed, they just have
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untreated ADD. Um, so easily distracted organization can be a challenge both for time and space. If you look
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at their rooms, their desks, their book bags, they tend to be late, not because they want to,
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but they actually don't start getting ready until, Oh my God, I'm late. Um,
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procrastination tend to put things off until someone's mad at them. Uh, or they're under a lot
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of pressure and impulse control issues where they might say something they shouldn't say or do
00:25:05.140
something that is not helpful. And if you have three of those, probably worth picking up the book or
00:25:15.900
getting an evaluation. I have a free ADD type test online. If you go to ADD type test.com,
00:25:25.440
you can see, you know, based on how you answer the questions, do you likely have ADD and which
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of the seven or combination of seven types you have, because people can have more than one type.
00:25:45.600
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amazing. Go to share the arrows.com. What do you think is, I guess there's probably not one
00:26:55.120
cause of ADD, but do you think, I know that you've talked about the genetics. I know that
00:27:01.440
you've talked about the things that we eat. Is there anything else that you see as the impetus
00:27:07.380
for why there seems to be so much ADD today? Or maybe you think it's just being diagnosed better
00:27:12.860
than it used to be, but some people see it as a rising and alarming trend.
00:27:17.820
No, I think it's going up. I think the number one cause is genetic. It runs in your family. Like
00:27:25.260
you could see some of the symptoms going generationally in your own family. I think
00:27:33.580
ADD, ADHD is real. And when left untreated, it can devastate people's lives. Having said that,
00:27:42.860
concussions increase the risk of ADD. Toxic food increases the risk of ADD. Toxic products you put on
00:27:54.380
children's bodies increase the risk of ADD. I like we're having this discussion now about environmental
00:28:05.680
toxins and brain health and issues like ADD and autism. I think all the screen time that, you know,
00:28:16.720
you shouldn't give gadgets to kids. You shouldn't give devices to kids. They were unleashed on our
00:28:24.720
society, video games, smartphones, iPads. They were unleashed on our society for profit
00:28:34.480
with no neuroscience study ahead of time. And I really like it when neuroscience turns into public
00:28:44.400
policy. For example, we know social media is damaging to children's mental health. And Australia
00:28:54.820
just banned it for kids under 16, you know, science to policy. California just said, nope, can't start
00:29:05.580
school before eight o'clock in the morning. Yeah. Because kids who sleep just an hour less than their
00:29:13.540
peers have a higher incidence of anxiety, depression and suicide. And so now we're going to protect
00:29:19.380
their sleep. So no more showing up at school at five o'clock in the morning, uh, or zero periods.
00:29:27.220
I like that. And I was just involved in a bill in Arizona, uh, banning ultra processed foods
00:29:36.820
in schools, science going to public policy. And, uh, I, I think we have to be more thoughtful
00:29:47.300
because this mental health epidemic in children, it's, it's going to impact the future of our
00:29:56.420
country. I don't know if you know, but 77% of young people do not qualify for military service
00:30:03.780
because of their physical or mental health. That's a national security crisis.
00:30:09.460
Wow. Yes, absolutely. Um, RFK today, as we're recording, this is announcing a ban on artificial
00:30:17.760
dyes. I believe California already banned one of the dyes, um, maybe red 40, or I don't remember
00:30:25.940
which one it was, but certainly some of the dyes, as you said, can cause symptoms of ADD. I know RFK
00:30:31.980
has been talking about that as well. Um, when you see some of the new public policy coming out
00:30:37.140
of this administration over the past few months in relation to these possible environmental causes,
00:30:42.020
what are your thoughts? I'm a huge fan. In fact, I gave a lecture in Washington in October to
00:30:50.420
the, um, integrative medicine for mental health conference, like a thousand doctors. And, and I
00:30:58.580
said, cause I, and I try to be a political because I want to help everybody. But if the current
00:31:04.660
administration stayed the one before, absolutely nothing was going to change in our health. But
00:31:12.500
if RFK was in the new administration, we're going to have big discussions and have discussions on
00:31:20.740
fluoride, you know, places where they're fluoride in the water, children have lower IQs. Well, that's not
00:31:27.660
okay. Um, and artificial dyes and sweeteners. I actually have, and it's got the most views of
00:31:36.640
anything I've published over the last decade of a scan of a child off and on red dye number 40.
00:31:46.940
And the parents brought them to me because it's like, you know, whenever he gets anything
00:31:51.740
red, he goes into a rage and he's completely not himself. And I'm like, well, let's scan him off
00:32:00.520
and then on red vines. Um, and it flamed his brain in a very bad way. I mean, it clearly changed his
00:32:14.000
brain. So if we don't have to use these things and clearly we don't have to use them,
00:32:21.720
right. They're banned in places like Canada and Europe. Um, why would we allow them unless we're
00:32:30.500
just bowing down to the food industry that wants to use them because they're cheap? And it's like,
00:32:37.340
oh, well, food will cost more. Well, how much does it cost to have a brain that's not working right?
00:32:43.740
I mean, what is that actually doing to the soul of the individual people and the fabric of
00:32:51.520
America where last year there were 340 million prescriptions written for antidepressants?
00:32:59.080
It's like, what's the first, the smartest, the easiest thing to do? And what I learned is
00:33:09.580
most psychiatric illnesses, ADD, autism, depression, bipolar disorder are not mental health issues.
00:33:18.940
They're brain health issues. And this one idea changes everything. Get your brain healthy and
00:33:29.200
your mind will follow. And if these chemicals are not good for gut health, if they're not good for
00:33:38.040
brain health, well, why do we allow them in food? And the food companies will go, they're not proven
00:33:44.140
to be bad. But that's the wrong question. The question should be, are they proven to be safe?
00:33:52.920
And they're not. And there's actually this fascinating new study on aspartame,
00:34:02.460
They gave mice aspartame and NutraSweet or what's in Diet Coke. And it made the rats anxious. But you know
00:34:15.080
what else it did? It made their babies and their grandbabies anxious. And so put something so simple
00:34:24.320
to be causing or be part of what's causing the anxiety epidemic because aspartame is in 6,000
00:34:34.840
products. And I used to think of Diet Coke or Diet Pepsi is free. And I have a new book coming out in
00:34:45.040
December called Change Your Brain, Change Your Pain. And I remember, and I think it's right around 1991,
00:34:51.720
I'm seeing patients in my office and this one lady comes to me and she said, I stopped aspartame
00:35:00.540
and my arthritis went away. And at the time I was 35 and I had arthritis in my hands and my knees
00:35:08.880
and it was terrible. And I had trouble getting off the floor, playing with my kids. And I'm like,
00:35:15.000
oh, that's so interesting. Because I think most of what I've learned, I've actually learned from my
00:35:19.060
patients. And so I stopped aspartame. At the moment, I was drinking Diet Pepsi like she was my best
00:35:25.120
friend. Like I'd have a liter a day because I thought I was free. And then I stopped and my pain
00:35:30.780
went away. And I'm not that smart. And so I'm like, two months later, I'm like, let's try this again.
00:35:38.380
Because I really liked the taste of Diet Pepsi. And I had the worst flare. And I just broke up
00:35:47.040
with aspartame. It's like, you know, I love it. It doesn't love me. Allie, I don't know if you've
00:35:53.660
ever been in a bad relationship. I have. I'm not doing it anymore. I'm married to my best friend.
00:36:00.520
I'm damn sure not doing it with food. Yeah. If there's something that hurts me,
00:36:12.340
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Okay. You mentioned something interesting about, you said, if the last administration stayed put,
00:37:41.940
we wouldn't be having all these conversations. And this is not really a political question,
00:37:46.660
but I am interested in why. And not only why would the last administration or people in
00:37:52.600
bureaucracy not be interested in investigating all of these causes is you mentioned huge cost of
00:37:58.380
having so many people on antidepressants and things like that. But also you mentioned that
00:38:03.260
so many people in your field in psychology don't want to look at the brain. They don't want to look
00:38:08.120
at root causes. They just treat everyone the same. So what is behind that lack of curiosity?
00:38:13.680
Well, I think it's, well, we don't, this is not what we do. So we don't do it. And when I started
00:38:23.680
imaging, I went to all day lectures at the American Psychiatric Association on brain specced imaging
00:38:32.000
in child psychiatry, in adult psychiatry. And it was a very exciting time, but very quickly they realized
00:38:41.700
imaging didn't go with the status quo. Imaging disrupts everything. And they're like, oh no,
00:38:48.200
you shouldn't scan. And growing up, my dad called me a maverick because when you told me I shouldn't
00:38:55.620
do something, I always went, why? Well, why shouldn't I do that? Right? This is how my brain works. And so
00:39:03.760
when they told me I shouldn't do it, I'm like, well, why? How do you know unless you look? And I had
00:39:10.400
already so much experience, them telling me not to do it. I didn't really care. They weren't my boss.
00:39:16.700
I worked for myself and my patients. But it got diminished because it disrupts the status quo.
00:39:29.840
There's a great book about scientific revolutions. It's actually written in 1962 by Thomas Kuhn.
00:39:36.980
And he said, revolutions happen in six stages. One is just normal science, just going along with the
00:39:46.800
status quo. Two is somebody notices a problem. I would diagnose someone with ADD, how I was taught
00:39:55.880
based on symptom clusters. I'd put them on a stimulant. Some people would miraculously get better
00:40:02.400
and some people wanted to kill themselves. I hated that. I hated feeling I don't have all the
00:40:10.220
information. I don't like making people worse. It upsets me. And so somebody notices a problem.
00:40:20.040
I noticed a problem. And I'm not the only one. Stage three is the status quo notices a problem,
00:40:28.020
but they don't want to change the financial model. So they make small incremental changes,
00:40:35.980
hoping that will satisfy the population. And so we've now had six versions of the DSM. And so DSM-3
00:40:44.780
that I trained under, that was the term ADD with or without hyperactivity. DSM-3R, revised,
00:40:54.020
changed the name for really no good reason, to ADHD, highlighting the hyperactive component of it,
00:41:02.300
basically throwing away all the ADD without hyperactive people.
00:41:10.300
Stage four of the revolution is someone creates a new mousetrap. Detailed histories, cognitive testing,
00:41:18.620
imaging, imaging, brain health. Stop calling it mental illness. Start calling it what it really is.
00:41:26.740
These are brain health issues. And that's our innovation. Stage five is the most predictable of
00:41:34.740
all stages is the rejection. I've gone through it in more ways than we want to talk about. But I've
00:41:43.740
been called a charlatan and a snake oil salesman. I'm on the cover of the Washington Post magazine in,
00:41:51.620
I think it was 2011. Dr. Raymond's the most popular psychiatrist in the country. And most psychiatrists
00:41:59.700
think that's a bad thing. So, and 2020 interviewed me in 2005. And they start the interview with Brad
00:42:12.360
Peterson, the child psychiatrist from Columbia, thinks you should be arrested for your work. That's the
00:42:19.820
first question on the interview. And, and the journalist said, how would you respond?
00:42:31.800
And I was on the speech team in college and my speech coach said, when you don't know what to say,
00:42:37.120
take a breath, smile, it'll come to you. So I took a breath, I smiled. And I said, that's so
00:42:43.240
interesting. Last week, someone told me I should win a Nobel prize. This week, you're telling me I
00:42:49.460
should be arrested. Sort of keeps me balanced. And I actually got to meet Dr. Peterson a couple of
00:42:56.660
years later. And this year, we published a huge study together on depression and imaging. So, you
00:43:06.040
know, that's sort of keeps me going. And stage six is just the acceptance. And, you know, I've been to
00:43:12.800
the White House with the new administration, we're working on a brain health revolution. That's sort of
00:43:19.680
the big idea. I've never had anyone except my friend at the White House asked me, how big can you
00:43:26.920
think? And I'm like, I think President Trump should declare the next 10 years, the decade of brain
00:43:37.600
health. And when you think of it as mental health, Ali, people make diagnoses based on symptom
00:43:46.600
clusters with no biological data. And it gets us into the mental mess we're in. When you think of
00:43:53.640
it as brain health, whether it's ADD or depression, it's like it's brain health. Oh, we have to eat
00:44:01.920
healthy. We need to exercise together. We need to train our brain to help us rather than hurt us.
00:44:10.920
And even if I use medicine with someone, I use less of it. Because I'm supporting the health
00:44:21.220
of their brain. And that's the revolution. I want you to be a brain warrior to know. And so brain
00:44:32.560
warriors are armed, prepared, and aware. Our society currently is not for us. It's against us. And we
00:44:43.720
have to be serious about our brains and the brains of those we love.
00:44:51.700
What comes to your mind when you hear the phrase chemical imbalance? That has long been used to
00:44:59.140
describe what people with depression or anxiety have, that they have a chemical imbalance. I guess
00:45:03.900
usually they're described as having not enough serotonin. And they say they're taking their
00:45:09.980
antidepressants or anti-anxiety medication in order to remedy this. Like, do you follow that? Do you
00:45:17.500
think that it's a chemical imbalance issue? Well, I think supporting neurotransmitters
00:45:24.860
can be very helpful. But I think it's way more complicated than that. One of the big lessons I
00:45:33.080
learned is if you want to keep your brain healthy or rescue it, we have to prevent or treat the 11
00:45:39.420
major risk factors that steal your minds. And the mnemonic I have that I developed since I wrote
00:45:46.920
Healing ADD is called Bright Minds. So B is for blood flow. Low blood flow is the number one brain
00:45:54.440
imaging predictor of Alzheimer's disease, depression, and ADHD. And so what can I do to support the blood
00:46:03.800
flow of my patients? And for each of these, these are the things to avoid, like too much caffeine,
00:46:11.700
nicotine, alcohol, marijuana, being sedentary. They'll decrease blood flow. What increases blood flow?
00:46:21.100
Exercise, especially coordination exercise for your son, unlike table tennis. Teach him to be great at
00:46:29.880
ping pong. His focus will go way up if you do that because it's boosting cerebellar activity.
00:46:37.140
Cerebellum is a part of the brain, back bottom part of the brain involved in coordination, but it also
00:46:42.060
turns off in ADD. So constantly turning that on with coordination exercises. Great.
00:46:49.000
R is retirement and aging. Like when you stop learning, your brain starts dying. I is inflammation,
00:46:58.080
which we think is the root of depression. And why during COVID did depression and anxiety disorders spike?
00:47:09.460
Because COVID causes brain inflammation. I saw it repeatedly on our scans.
00:47:20.620
G is genetics. Yes, things run in families. I adopted my two nieces because both their parents are drug
00:47:27.340
addicts and they need to be on an addiction prevention program their whole life. And if you have ADD in your
00:47:37.040
family, it's like, okay, so let's do the things that decrease the expression of ADD, exercise, a healthy diet,
00:47:46.820
omega-3 fatty acids, especially EPA, magnesium, zinc, those things that can be helpful.
00:47:56.300
There's a study, five studies on ADD with saffron. I'm a huge fan of the spice saffron.
00:48:06.500
So if I have it in my family, I'm always on a prevention program. Like I have obesity and heart
00:48:14.800
disease in my family, but I'm not overweight and I don't have heart disease, but I think about it
00:48:21.400
every day. I am on an obesity, heart disease prevention program every day. H is head trauma,
00:48:31.500
major cause of psychiatric problems, including ADHD. If you didn't have symptoms and then you had a car
00:48:39.620
accident, now you have symptoms. You know, if I did eight types of ADD, type eight would be head
00:48:45.900
trauma-induced ADD. T is toxins, which we talked a little bit about. And mental health stuff.
00:48:56.640
There I include adverse childhood experiences on a scale of zero to 10, how many bad things happen to
00:49:03.200
you as a child? Because trauma and stress increase the expression of ADD. And how negative are you?
00:49:11.680
Because negativity bias tends to go with low activity in the areas of the brain that are low
00:49:19.180
with ADD. And then just to finish it off, I is immunity and infections. N is neurohormone
00:49:27.080
disorders. Anybody who's being diagnosed with ADD, somebody should check their thyroid.
00:49:33.740
D is diabetes. 20% of our kids are obese. I mean, it's just ridiculous.
00:49:39.420
And S is sleep. And these gadgets we have are stealing our sleep. So that's really sort of my
00:49:47.340
holistic plan. As opposed to your scan shows this, take this drug. It's like, let me learn about your
00:49:58.680
life. Let me test your brain. Let me look at your brain. And now let's work hard to get it healthy.
00:50:04.420
Mm-hmm. And I don't know how much you talk about this, but when you talked about blood flow,
00:50:08.900
I learned for the first time is my husband, he had a scan, not one of your scans, but he looked
00:50:14.620
at a deviated septum. And the doctor said, you know, deviated septum, that obviously can make it
00:50:21.020
harder to breathe. It can cause sleep problems, which can later contribute to heart problems and
00:50:25.880
things like Alzheimer's and dementia. And it just got me thinking. There's a lot now about,
00:50:31.240
I think it's called myofacial therapy for kids. When kids are mouth breathers and they snore at
00:50:38.000
night, that apparently can be an indication that they're not getting enough oxygen to their brain,
00:50:43.040
which I guess may contribute to causing ADD symptoms. So I don't know if that's something
00:50:47.540
that you talk about a lot, but I thought it was interesting that you brought that up because I've
00:50:51.760
been hearing a lot of chatter about that subject. And I think it's a very exciting area of medicine
00:51:01.460
that because we're not chewing hard things like we did in the past, that our face and the bones in
00:51:15.460
our muscle, the bones in our face are actually collapsing a little bit, making it harder to
00:51:21.040
breathe, which will decrease oxygen and give more problems like learning problems or behavior
00:51:27.740
problems. And having that assessed by dentists that do that is worth exploring.
00:51:37.800
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00:52:57.520
I want to spend the last few minutes talking about marijuana. This is something that you've talked
00:53:09.220
about a lot, especially marijuana use in adolescence. It's affecting their brains. Is that correct?
00:53:16.120
I hate what's going on in our society. I mean, it's visceral for me. When I started looking at the
00:53:23.880
brain, a common patient I would see is someone who is 16, who didn't have a history of ADD. But then
00:53:33.840
all of a sudden, they look like they have ADD in ninth grade, 10th grade, 11th grade, their parents
00:53:40.260
bring them to me and they're like, I think they have ADD. But they didn't have it in fourth grade.
00:53:47.320
And I'll look at their brain and their brain looks toxic. It looks older than they are. And
00:53:56.180
I'll get the kid by himself. I'm like, what's going on? And they go, promise you won't tell
00:54:04.380
my parents. It's like, I can't do that. But I want to know what's going on because your brain looks
00:54:10.720
toxic. And then they tell me either about alcohol or marijuana. And I see it as a major cause of
00:54:22.800
learning problems, focus problems. And teenagers who use marijuana have an increased risk of anxiety,
00:54:32.260
depression, suicide, and psychosis in their 20s. And the idea that it's innocuous is a lie.
00:54:40.720
I published a study on 1,000 marijuana users. It's the largest study ever done until just a couple of
00:54:51.660
months ago. And every area of the brain was lower in blood flow. And then just a couple of months ago
00:54:57.720
in JAMA, there's a study on another 1,000 marijuana users. So I had nothing to do with it.
00:55:05.740
And the learning and memory parts of their brain were significantly less active.
00:55:14.880
Now, should it be legal? It's like, please don't put people who use marijuana in jail. That's a bad
00:55:20.800
use of resources. And my mother-in-law who had cancer, having her use marijuana so she'd eat,
00:55:29.560
I think that's absolutely appropriate use of it. But the idea that it's innocuous is just a lie.
00:55:38.440
And we're going to see this exact same thing with psilocybin. So you've probably heard, oh,
00:55:44.680
you should go on a mushroom trip. Oh, it treats depression. Oh, it treats PTSD. Oh, we should all
00:55:52.660
like open our minds. The problem is, is it might have some specific benefits. But whenever something
00:56:04.020
like that comes out, all the teenagers rush to it. And the visits to emergency rooms for psilocybin
00:56:12.520
psychosis has gone up 300%. And I'm like, let's be careful. Let's do the simple things to get your
00:56:23.240
brain healthy and be careful with the things that hurt you. What about vaping? I went to a concert
00:56:30.200
the other day with my husband. We were around a lot of college students. And there were all kinds
00:56:34.800
of substances. But one thing I noticed was the subtle vaping. And I didn't even really know what
00:56:39.820
these devices look like. But it seems like it's pervasive, at least among one portion of the
00:56:44.660
population. Does that have the same deleterious effects on the brain? It's not good. It constricts
00:56:50.080
blood flow to the brain. Plus, with vaping, you get all those other chemicals, right? People think
00:56:56.240
vaping is a healthier form of smoking. It's not. And it's actually more addictive. And quitting cigarettes
00:57:05.960
is harder than quitting cocaine. Wow. I didn't know that. And cigarettes, do they have the same
00:57:14.620
effect, I'm guessing, is what you're talking about, constricting blood flow and all of that?
00:57:20.420
Yes. But an interesting study on comparing marijuana and cigarettes, marijuana actually
00:57:26.760
caused more lung damage than cigarettes do. Really? Okay. I also didn't know that. Yeah,
00:57:31.980
you hear a lot about how weed is no big deal. It's less of a big deal than alcohol. That's kind
00:57:38.540
of the argument to popularize it, to mainstream it, to commercialize it. And I don't know if that's
00:57:43.300
true, if it's more or less dangerous than alcohol. I don't really see a good argument,
00:57:47.240
though, for popularizing yet another toxin that we know is harming the brains of young people.
00:57:53.300
Right. Yeah. Okay. So a parent is listening out there and they're thinking, okay, a lot of the
00:57:59.060
things that you're saying, they either apply to me or my spouse, or I see this in my child
00:58:04.220
and they don't know what to do. What would you say their first step should be in just
00:58:08.920
getting on the right track and taking control of their brain health?
00:58:14.480
Well, the first thing, the first simple thing to do is just ask yourself this one question every day,
00:58:20.280
is what I'm doing good for my brain or bad for it? And if I don't know, I look it up.
00:58:25.620
Um, they could start with my book, Change Your Brain every day. I've written 42 books.
00:58:33.940
People go, where do I start? And I'm like, start with Change Your Brain every day. Um,
00:58:39.460
because it's one of my newest books. It's also 366 short essays on the most important things I've
00:58:46.760
ever said. So I try to like summarize, um, my latest thinking and, and it's simple.
00:58:55.160
But if, and if you've been struggling with your brain or mental health, call one of our clinics,
00:59:01.840
we have 11 of them. You can go to Amen Clinics, Amen, like the last word in a prayer,
00:59:08.500
clinics.com and learn where they are. Also follow me on Instagram or TikTok.
00:59:13.940
That's a good place to start. Well, Dr. Amen, thank you so much. I'm so grateful for all the work
00:59:18.600
you've contributed to this conversation and just how you're leading the way in so many ways. I really
00:59:23.280
appreciate it. Thanks, Sally. What a joy to spend time with you. Thank you.