Ed. note: May is Mental Health Month. The COVID-19 epidemic—already a source of stress and anxiety for many of us—may be especially challenging for people who experience or care for someone with brain health challenges. While knowledge alone doesn’t alleviate confusion or fear, understanding brain function may help us come up with ways to cope and even help ourselves and others.

Mental illness rates are up, yet neuroscientist, psychiatrist and brain-imaging expert Daniel G. Amen, M.D., says we should rethink our notion of these types of challenges. After all, standard treatments are often ineffective.

In his new book “The End of Mental Illness: How Neuroscience Is Transforming Psychiatry and Helping Prevent or Reverse Mood and Anxiety Disorders, ADHD, Addictions, PTSD, Psychosis, Personality Disorders, and More” (Tyndale Momentum, March 2020), he shows readers how to enhance their brain health and mood. Read on for a Q&A with the acclaimed author.

Dina Cheney: What is mental illness?

Daniel Amen: I hate the term “mental illness,” and you should, too. Based on our brain-imaging work (more than 160,000 scans and growing), it has become crystal clear to us that, as psychiatrists, we are not dealing with mental health issues but rather with brain health issues that steal your mind.

DC: How common is mental illness, and is it becoming more prevalent?

DA: According to a large epidemiological study, 51 percent of the U.S. population will struggle with a mental health issue at some point in their lives. And mental health issues are on the rise, especially among adolescents and young adults.

DC: What are the causes of mental illness?

DA: Based on our brain-imaging work and more than 30 years of clinical practice, we have identified 11 major risk factors that harm the brain. We developed the mnemonic BRIGHT MINDS to help you remember them.

• B is for blood flow. Low blood flow seen on SPECT (the brain-imaging technology we use) is associated with many psychiatric symptoms and is the No. 1 brain-imaging predictor of Alzheimer’s disease.
• R is for retirement and aging.When you stop learning, your brain starts dying.
• I is for inflammation. Chronic inflammation harms your organs and can destroy your brain.
• G is for genetics.Brain health issues tend to run in families.
• H is for head trauma.Mild traumatic brain injury is a major cause of psychiatric problems, but very few people know it.
• T is for toxins. Exposure to environmental toxins can increase the risk of mental illness symptoms, memory problems and dementia.
• M is for mind-storms. Some diseases of the brain start by damaging the brain’s wiring or impairing the ability to create the right amount of electricity.
• I is for immune system problems and infections. These types of problems can increase your risk of brain fog, mental health problems and memory issues.
• N is for neurohormone issues.Hormonal imbalances have been associated with symptoms, such as anxiety, depression, difficulty concentrating, mood swings, mania, psychosis, brain fog and more.
• D is for diabesity. The word “diabesity” combines diabetes and obesity, both of which contribute to greater risks of depression, bipolar disorder, addictions, memory problems and more.
• S is for sleep. Sleeping fewer than seven hours per night has been associated with a higher risk of dementia, depression, ADD/ADHD and other issues.

DC: How effective are standard treatments for mental illness? If they are ineffective, why?

DA: Because traditional psychiatrists don’t look at the brain, they are basically throwing darts at the problem in the dark. For example, one large study found that taking antidepressants didn’t work for more than half of depressed patients. At Amen Clinics, our patients on average have failed 3.3 providers and five medications prior to seeking our help.

DC: Is it a bad idea to diagnose and treat people based on symptoms alone?

DA: Yes. Symptoms don’t tell us anything about the underlying biology of what’s causing the symptoms. Psychiatry remains the only medical field that doesn’t look at the organ it treats. Because of this, misdiagnosis is common. For example, a 2008 study reported that 69 percent of people with bipolar disorder are initially misdiagnosed.

DC: What we do to manage or reverse mental illness?

DA: Preventing or treating the BRIGHT MINDS risk factors [as follows] is the key to minimizing or reversing mental health issues.

• B is for blood flow. Boost blood flow by engaging in regular exercise. The following four types are great for your brain:
  • Burst training: [It] raises endorphins, lifts your mood and makes you feel more energized.
  • Strength training: [It] decreases anxiety, increases energy and improves mood. I recommend two 30- to 45-minute weightlifting sessions per week.
  • Coordination activities: Table tennis has been found to improve social behaviors and executive function in children with ADHD.
  • Mindful exercise: Yoga, Pilates and tai chi help anxiety and depression and increase focus and energy.
• R is for retirement and aging.Slow the brain’s aging process by exercising your brain with new learning. The best mental exercises involve acquiring new knowledge and doing things you haven’t done before.
• I is for inflammation. Consume prebiotics and probiotics (or probiotic supplements) that promote good gut bacteria. Prebiotics are dietary fiber found in apples, cabbage, artichokes, onions, leeks, asparagus and root veggies. Probiotic-rich foods include kefir, kombucha, unsweetened yogurt (goat or coconut), kimchi and sauerkraut.
• G is for genetics.Know your family history and avoid any risk factors that accelerate disease for your genetics.
• H is for head trauma. Protect your head from injury. Wear a helmet while riding a bike, avoid contact sports and don’t climb ladders. And actively engage in healing any past concussions with neurofeedback and other therapies.
• T is for toxins. Quit smoking, address any drug or alcohol abuse, and reduce your use of unsafe personal-care products and chemical-laden household cleaners.
• M is for mind-storms. Avoid anything that increases mind-storms, such as sugar, skipping meals, red dye, MSG and excessive screen time. Neurofeedback may calm abnormal electrical feedback.
• I is for immune system problems and infections. Avoid allergens and consider going on an elimination diet for 30 days. Cut out sugar, gluten, dairy, corn, soy, artificial colors, additives and preservatives to see if you feel better.
• N is for neurohormone issues.Check your hormone levels and optimize them, if necessary.
• D is for diabesity. Limit or eliminate foods that increase the risk of diabesity: high-glycemic low-fiber foods, processed foods, artificial sweeteners and additives, and potential allergenic foods (see above).
• S is for sleep. Find out if physical health problems, like sleep apnea, chronic pain or thyroid issues, are stealing your sleep. If so, treat them.

Photo credit: Imani Clovis, Unsplash