Sorry for absence folks, but in the meantime, I have recruited a guest blogger. CereScan's own Jenny Faherty. Ms. Faherty works with patients to help them better understand the process involved in getting a brain SPECT scan. In addition, in conjunction with the MDs, she helps patients understand what the results me to them and their specific cases. She, along with the other clinical staff at CereScan, can really teach you a lot about brain behavior relationships. I hope you enjoy the post. Thanks Jenny.
When I was working on my Master’s degree, one of my favorite classes was Abnormal Psychology. As I learned about the various categories of psychiatric disorders and studied the symptoms and conditions of the DSM-IV (Diagnostic and Statistical Manual for Mental Disorders, 4th ed.), I was fascinated by the many different ways the human mind could diverge from “normal.” That is until I noticed the familiarity of certain symptoms in my own brain at times: fatigue and poor appetite; Was I depressed?; racing thoughts and spending too much money… Was I bipolar?; some unremitting G.I. symptoms of unknown origin… Did I have somatization disorder? The incessant drive to make straight A’s… Maybe I had obsessive compulsive disorder (at least this got me my money’s worth of tuition). The truth, I came to learn, is that we all have a little of a wide range of “psychiatric” symptoms at times in our lives, and this pretty normal. The difference however, between those with psychiatric conditions requiring treatment and those who don’t is the degree to which symptoms impair their everyday functioning.
In my previous work as a psychotherapist I tried to follow the diagnostic criteria and “boxes” of the DSM-IV, but often found myself at a loss as to how to accurately diagnose certain patients – those people with a range of symptoms that crossed over a few different categories – but none that completed the picture of any one “box.” They were typically on a few different medications prescribed by their doctors, but yet they didn’t seem to get better. For some patients, it seemed as though their brains never turned off, and for others it seemed their brains could never get going. In therapy sessions we dug into past history, experiences, projections, thought processes, etc., but in the end all of that didn’t seem to make that much of a difference in the intensity and range of their symptoms. Perhaps I was not that great as a therapist, or perhaps there were missing pieces of the puzzle (I vote for the latter).
Having been in the fascinating field of brain imaging for five years now, I have learned so much about those missing pieces of the puzzle. Consider this: The brain is the hard drive for all that we do, think, feel, see, smell, touch, remember and so forth, thus a balanced brain keeps the mind and body running smoothly. Conversely, a brain with certain areas out of balance can result in various kinds of dysfunction. For example, overactivity in certain parts of the brain (i.e. the limbic system) can be the underlying cause of certain mood and anxiety disorders, while low activity in certain parts (like the frontal and temporal lobes) can affect cognitive function, empathy, insight, learning, balance, anger control and memory. Since there are a number of symptoms that cross over the boundaries of different diagnostic categories (or “boxes”), when we look at a person’s specific brain function, we can help determine the source of the problems, which in turn provides a compass for more precise treatment strategies. For example, consider the symptoms of agitation and restlessness. Is it from ADHD? Or Depression? Or a bipolar disorder? Or anxiety? Without looking “inside” the brain, it can be difficult to understand the genesis of the problem. Since medication and treatment for all of these disorders are different, it so important to understand where the source, otherwise the symptoms can get worse or remain unchanged. Another example that comes to mind is the differentiation of depression from the depressive phase of a cycling mood disorder (such as bipolar). Do people typically go to the doctor when they are feeling really good, being super productive and full of energy? I think not. They tend to go when they crash and are depressed. This is then what the doctor and therapist see – the symptoms of depression, for which antidepressants are often prescribed. But as many of you already know, anti-depressants can be ineffective if not quite dangerous for an individual who actually has a bipolar process going on. Hence, the importance and great clinical value of a functional brain scan for the differential diagnosis.
The more I write, the more excited I get about the contributions of brain imaging and neuroscience to help doctors and therapists help their patients feel better. I only wish I could turn back time with what I know now to help those puzzling patients in my past.