Relatable with Allie Beth Stuckey - Ep 1193 ｜ A Balanced Approach to ADD Medication ｜ Guest： Dr. Daniel Amen

00:00:00.860 Wellness Wednesday is back today with Dr. Daniel Amen. He is probably one of the best known

00:00:08.220 psychiatrists in the country, and he has a novel approach to looking at brain health when it comes

00:00:15.120 to ADD, ADHD, autism, depression, anxiety. And today we are going to talk about the mainstream

00:00:23.460 view of these diagnoses versus how we can actually care for our brains in a way that helps us. He is

00:00:31.100 not anti-pharmaceutical, but he is holistic health, looking at the whole picture of the body. And so

00:00:37.400 today he is going to break that down for us. He is also going to tell us what to look for if you

00:00:43.700 or someone you love may be ADD. It was an absolutely fascinating conversation. We'll also get to

00:00:49.560 the damaging effects of weed on people's brains and our society. It is not as innocuous as you

00:00:56.240 are being told. Just an incredible conversation you will learn so much from. I know I did. We've

00:01:02.340 got all of this and more on today's episode of Relatable. It's brought to you by our friends

00:01:06.060 at Good Ranchers. Go to goodranchers.com, code Allie. That's goodranchers.com, code Allie.

00:01:19.560 Dr. Amen. Thanks so much for taking the time to join us. I know a lot of people listening and

00:01:24.780 watching, they follow you, have for a while, but for those who may not know, can you say who you are

00:01:29.920 and what you do? So Daniel Amen, I am a husband and a father and a grandfather to five, and I am a

00:01:41.640 psychiatrist, but I do things very differently than my colleagues. I actually think you should look at

00:01:47.640 the brain before you go about treating it. I have 11 clinics, and we have the world's largest database

00:01:56.200 of brain scans related to behavior, about 260,000 scans on people from 155 countries.

00:02:06.740 Wow. And can you tell me a little bit more about the scans? Because you mentioned that most people in

00:02:14.040 your field do not scan the brain before they diagnose an adult or a child with ADD. So what are

00:02:21.680 your scans and what do they set out to accomplish? So at Amen Clinics, we do a study called brain

00:02:29.260 SPAC imaging, SPAC, single photon emission computed tomography, is a nuclear medicine study that looks

00:02:38.780 looks at blood flow and activity, looks at how your brain works. And it tells us basically three

00:02:48.260 things, good activity, areas with too little or areas with too much. And then our job becomes about

00:02:59.340 balancing the brain. And why we do that when most others don't is, before I went to medical school,

00:03:10.940 I was an x-ray technician. And our professors used to say, how do you know unless you look? And when I

00:03:18.020 decided to be a psychiatrist, my first wife tried to kill herself when I was in medical school.

00:03:24.180 I took her to see a wonderful psychiatrist. And I realized this is a profession that can change

00:03:31.420 generations of people. But I joined the only medical specialty that never looks at the organ

00:03:41.000 it treats. And I thought then it was insane. And I just had no idea that I would be part of changing

00:03:51.020 it. And think about this with me. Why are psychiatrists the only medical doctors who never

00:04:00.640 look at the organ they treat? And because of that, Ritalin is controversial. For the wrong brain,

00:04:11.620 it's a nightmare. And for the right brain, it's miraculous. And how would you know ahead of time

00:04:20.180 if you didn't actually look at the physical function of the organ you're treating?

00:04:28.080 Right.

00:04:28.800 And, you know, SPECT is not the only way to look at the brain. Other people do PET scans. Other

00:04:35.280 people do quantitative EEG. Other people do functional MRI. I just love SPECT. And, you know,

00:04:45.100 because we built this database of experience, well, that's hard to replicate. And what we learned

00:04:53.540 about ADD or ADHD, it's just a different term for the same thing. That when people who have this

00:05:04.280 disorder try to concentrate, the front part of their brain shuts down. Where in a healthy population,

00:05:13.100 it turns on. So what does that mean? It means the harder they try, the worse it gets. And how would I

00:05:22.260 know that if I didn't look? How would I know a child's ADD was due to their brain working too hard

00:05:34.620 or not hard enough? And I can't tell. Like, I'm not a magician where I can, you know, divinate you

00:05:46.780 how your brain does this by your behavior because you can have the same symptom clusters

00:05:54.240 and have wildly different brain function.

00:05:57.000 Right. Okay. So it could be, are you saying that people with ADD, it could be that a part of their

00:06:03.840 brain isn't working hard enough or that it is working too hard? Or is everyone who is displaying

00:06:11.320 these kind of ADD symptoms, the inability to concentrate, do they all share that commonality

00:06:17.400 of the front part of their brain just shutting down when it should be turning on?

00:06:21.280 Not all of them. But in my book, Healing ADD, I talk about the seven different types. And

00:06:30.820 six of the seven have that sort of deactivation. But one of the types, the type we call the ring

00:06:40.360 of fire activates too much. And when you give them a stimulant, 80% of the time you disrupt them,

00:06:52.560 you make them worse. And they tend to be the ones we see. We typically don't see the sort of classic

00:07:01.700 ADD or the unattentive ADD because their pediatrician has seen them. And generally,

00:07:08.460 like, you know, the medicine helps them. We tend to see the treatment failures. And so

00:07:16.500 we see way more ring of fire than a typical child psychiatrist.

00:07:24.720 And what is ring of fire?

00:07:26.500 So ring of fire is where their whole brain is really much more active than it compared to healthy.

00:07:40.560 It's like the freeway is jammed. And the world comes at them too fast. They get easily distracted.

00:07:54.560 They tend to be rigid. And if things don't go their way, they tend to be upset. And if you stimulate

00:08:02.120 an already overactive brain, you generally make them worse. And so we do treatments, we use the scan

00:08:14.240 sort of like a map. And you've heard it said a picture is worth a thousand words, but a map is

00:08:22.120 worth a thousand pictures. A map tells you, okay, here's where you are and gives us direction on how

00:08:29.280 to get to where you want to go. And so it's like the traffic in LA where it's just way too busy.

00:08:39.880 And there are different kinds of ADD medications. Like you mentioned the stimulant. Would that be

00:08:44.240 something like Ritalin where you're trying to stimulate a part of the brain that is shut down?

00:08:50.820 Yes.

00:08:51.660 Okay. And then there's another kind, if you're over-stimulated brain,

00:08:54.660 you would take a different kind of medication that helps it calm down?

00:08:58.740 Yes. I actually like a supplement that I developed, goodness, 25 years ago that has GABA. GABA is an

00:09:08.080 inhibitory neurotransmitter, 5-HTP, which is the precursor for serotonin, and L-tyrosine,

00:09:17.160 which is the precursor for dopamine. And that tends to have a nice calming factor.

00:09:24.660 A balancing effect on the brain. And when I started scanning people in 1991, I came to realize

00:09:35.180 some of the meds we prescribed were actually harmful to the brain. And then I remember in

00:09:40.600 medical school, all medical students learn, first do no harm, use the least toxic, most effective

00:09:49.580 treatments. And because of that, I got very interested in natural supplements, lifestyle,

00:09:59.140 dietary interventions for the brain. So if you come to Amen Clinics, the first thing we're going to do

00:10:08.400 is take a really good history, do cognitive testing, do imaging. And then we don't think about,

00:10:18.400 well, what medicine would we use? It's, well, what lifestyle or natural supplement might we try

00:10:26.320 first to see if we can't get better balance to your brain?

00:10:33.080 But you do see a need in some cases for pharmaceuticals, because some would say no Ritalin

00:10:39.860 and ADD medications. They always suppress the personality. They take the uniqueness out of

00:10:45.400 the kid. And we shouldn't prescribe that at all. But it sounds like you're saying, and from what I've

00:10:49.500 read, these can be of benefit to people with certain kinds of ADD.

00:10:54.020 They can be miraculous, right? And I think withholding proper treatment

00:11:02.880 from an adult or from a child is like withholding glasses from someone who can't see. Now, I've been a

00:11:15.480 psychiatrist for 40 years. And when I prescribe a stimulant and it's the right thing for the person,

00:11:27.080 it doesn't make them depressed. It doesn't dull their personality. It helps them be who they really

00:11:35.020 are when their brain is healthy. Now, if you come at this with a preconceived idea that all medicine

00:11:43.320 is of the devil, well, then you can find all sorts of cases where these medications have made people

00:11:50.500 worse, because they all have black box warnings. Because if you give them to the wrong person,

00:11:57.260 they're going to make people worse. But there's a whole bunch of other cases where someone went from

00:12:06.040 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

00:12:15.320 early cases, I saw the son of a business person. And he's like, Dr. Amen, if you think I'm bad,

00:12:25.040 you should see my dad. And then I saw his daughter. And she said, Dr. Amen, if you think I'm bad,

00:12:31.220 you should see my dad. And then I saw the wife who didn't have ADD, but she was chronically stressed 1.00

00:12:37.280 because she was married to the guy that had ADD. And she's like, you have to help me with this

00:12:42.320 stress. And so finally, he's the fourth person in the family that came to see me. And the scan

00:12:49.840 totally convinced him he needed to take care of his ADD. And the next year, he made three times the

00:12:57.560 amount of money he'd ever made in his life, because he could focus. And so I think withholding

00:13:06.960 medicine is not the right thing. But don't give everybody who has ADD the same treatment. That's

00:13:16.420 like giving everybody who has heart disease, the same treatment, which is stupid, right? I mean, 1.00

00:13:26.060 there's a hundred different causes of chest pain. You don't give everybody the same treatment.

00:13:32.600 You try to go, well, what's the cause of the chest pain?

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00:15:03.780 A lot of people have a concern, specifically in young boys being diagnosed with ADD. Boys tend to

00:15:15.700 be more rambunctious than girls at an early age, can't sit still for as long. They want to be more 1.00

00:15:21.340 aggressive outside running around. And some people believe that because young boys don't always fit

00:15:28.440 into the perfect, you know, kindergarten paradigm when they're five, six years old, that they're

00:15:33.200 over-medicalized. Do you think that's true, that boys are kind of being punished for being boys told

00:15:39.180 they have ADD at a young age when maybe they're just young boys? Yes. Sometimes it's a maturational

00:15:47.260 delay, which is why if you have an active boy or girl, it's probably best for them to be older.

00:15:58.440 In their class, like my birthday's in July. So I was barely five when I started kindergarten.

00:16:07.940 Probably with what we know now, it would have been better to hold me back for a year because then I

00:16:14.880 would have, just think about it, almost 20% more brain development. Right. I think my wife was 0.98

00:16:21.760 actually four and a half when she started kindergarten. And what we now know, the brain needs time to 0.56

00:16:28.700 mature. So that's often one factor. Another factor we should talk about is diet. Things like artificial

00:16:40.760 dyes and sweeteners are rampant. They're like in 10,000 products in the United States. If you have a

00:16:51.480 processed food diet, you're much more likely to present like you have ADD. There's this great study

00:17:00.580 out of Holland that they actually replicated. And I think the original study was on 300 kids who had

00:17:07.800 ADD or ADHD. They eliminated gluten, dairy, corn, soy, artificial dyes, and sweeteners. And after

00:17:18.880 six months, 70% of them didn't have ADD anymore. Wow. And so shouldn't the first intervention

00:17:29.020 be, let's just clean up your diet and let's take away the dopamine stealers, your gadgets, 0.54

00:17:39.100 and get you more sun and more exercise and some simple nutrients like omega-3 fatty acids.

00:17:48.880 And see, like to me, that's imminently rational to before you give someone a stimulant that's going

00:17:59.160 to change their brain, let's just clean up your diet and your habits. And if after you clean up their

00:18:09.860 diets and habits, there's still a half an hour of homework takes them four hours to do that their

00:18:18.140 level of impulsivity is unacceptable, that they can't focus and they're not performing anywhere

00:18:26.480 near their ability in school. Well, then let's scan them and let's consider supplements or medication.

00:18:36.940 Something that I learned from your book is that it is a misconception that people with ADD

00:18:43.000 cannot focus on anything, that they're always just kind of like bouncing around like a jelly bean.

00:18:49.080 Some people with ADD can get very focused. I've seen this before. They can get hyper-focused on

00:18:55.860 something. They may be able to sit down and read, you know, an entire book in one sitting if they're

00:19:01.540 really interested in it. It's really that they can't concentrate on things that they don't want

00:19:07.520 to concentrate on, whereas someone without ADD would be able to. Is that correct?

00:19:12.920 That's correct. In fact, maybe we should talk about how do you know if you have ADD?

00:19:18.260 Yeah.

00:19:18.700 And the five hallmark symptoms. And the first one is short attention span, but not for everything.

00:19:28.240 It's short attention span for regular, routine, everyday things. Schoolwork, homework, paperwork,

00:19:36.140 chores, chores, the things that make life work. But, and this is what surprises people for things that

00:19:45.140 are new, novel, highly stimulating, or frightening. People with ADD can pay attention just fine.

00:19:56.960 Things that have their own intrinsic dopamine. So, you know, adults that have this because

00:20:05.280 they fall in love and for like four to six months, they're totally focused. But as the dopamine and

00:20:15.700 new love wears off, they can't pay attention at all. And their partner's like, hey, where'd you go?

00:20:24.700 Or if they're, have a new hobby, and they love it, they'll focus on it. Or they have a teacher they

00:20:36.580 love. That one class will be great, but the six other teachers are complaining they can't focus.

00:20:42.720 So, it's new, novel, highly stimulating, or frightening. And that's often why they like extreme sports.

00:20:54.720 Right.

00:20:55.040 Or why they can be risk takers. Because they're looking for the thrill. It's also why they tend to be

00:21:06.860 negative. And in Healing ADD, I talk about the games ADD people play. And the first game they play is

00:21:15.600 let's have a problem, is they pick on other people, they like poke at them, just so that they can sort of

00:21:21.720 get that reaction out of them. And I always tell parents, when the child hands you the rope to play

00:21:29.400 tug of war, don't pick up the rope. And there's a great parenting section in that book. The second

00:21:37.840 symptom is they're easily distracted. They see too much, they hear too much, they sense too much. It's

00:21:46.320 like the world comes at them too fast. And they hate tags in clothes, because they feel them. My first

00:21:58.540 wife had ADD, I write about that. And right after we got married, I went into our little apartment, and

00:22:06.000 we were staying in medical school, you know, in school housing. And all of my shirts had the tags cut

00:22:14.600 out. And I've never felt a tag in my life. And I took one of the shirts into the our little family

00:22:23.840 room. And I'm like, do you know what happened to my shirts? She goes, you had all those tags.

00:22:29.640 I hate tags. Don't you hate tags? Aren't you happy I did that? And I'm like, never felt a tag ever.

00:22:36.920 Please don't cut up my clothes. Yeah. I laughed when I heard that story when I was listening to your book.

00:22:43.800 And there's so much, and I won't interject too much. But I, there was so much as I was listening,

00:22:48.760 I was like, wow, this reminds me of this person. This reminds me of this person. This reminds me of me.

00:22:52.560 My grandmother lived with us growing up. And she would always, I would always have her cut the 0.99

00:22:57.320 tags out of all my clothes. And to this day, I cannot stand tags in my clothes. I feel it all day.

00:23:03.440 It's like the princess and the pea. And I have plenty of other things in this book that remind

00:23:07.600 me of myself. But I, I laughed when I when I read that, because I can relate to her, the tags have

00:23:14.180 always bothered me. Well, if you have, you know, the way we often diagnose ADD in women is they bring 1.00

00:23:21.580 their children to us. Uh, because women often do not get diagnosed. So maybe more over diagnosed, 0.99

00:23:30.460 over diagnosed in boys, but not in girls. It's probably under diagnosed in girls because we still

00:23:38.900 have serious gender bias in this country. And if a little boy is having trouble, the parents get upset.

00:23:46.540 And they're like, he's gonna have to take care of her family someday. And if a little girl is having

00:23:51.960 trouble, they're like, Oh, maybe she's not that smart. We hope she marries somebody nice. And that's 1.00

00:23:57.400 completely irrational. Because if anything, I just did a post of my wife and I do a podcast together

00:24:06.780 called change your brain every day. And we were talking about energy. And we have three generations

00:24:13.200 now tired women, because they're doing way more than taking care of the house and the kids. Uh, 1.00

00:24:20.960 and if they have ADD, they often look depressed. When they're really not depressed, they just have

00:24:27.180 untreated ADD. Um, so easily distracted organization can be a challenge both for time and space. If you look

00:24:38.060 at their rooms, their desks, their book bags, they tend to be late, not because they want to,

00:24:44.220 but they actually don't start getting ready until, Oh my God, I'm late. Um,

00:24:51.340 procrastination tend to put things off until someone's mad at them. Uh, or they're under a lot

00:24:57.500 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

00:25:33.840 of the seven or combination of seven types you have, because people can have more than one type.

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00:26:43.440 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.

00:31:46.540 Wow.

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?

00:32:58.300 Wow.

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 0.92

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,

00:33:58.680 because I'd be happy if they banned that too.

00:34:01.000 And that's in like Diet Coke.

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,

00:36:05.320 I have no interest in it.

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00:37:36.860 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 0.99

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 0.78

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 Last sponsor for the day is Preborn. Preborn is helping save the lives of babies inside the

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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 0.94

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, 0.98

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.

00:58:33.700 Wow.

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.

00:59:28.020 Thank you.

00:59:34.700 Thank you.

00:59:36.800 You

Relatable with Allie Beth Stuckey - May 21, 2025

Ep 1193 ｜ A Balanced Approach to ADD Medication ｜ Guest： Dr. Daniel Amen

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