Dr. Daniel Amen has a crazy idea.
He believes that traditional psychiatry, rather than merely discussing the issues pertaining to mental disorders, could be improved with the help of images of the brain, among other innovations.
The founder of Costa Mesa-based Amen Clinics Inc., a chain of psychiatric clinics, claims that brain images it uses help provide a more accurate diagnosis of patients, and therefore more effective treatment.
Psychiatry today is still largely practiced the same way it was years ago—a diagnosis is formed based on patient-reported symptoms, and then medication at a dosage is prescribed, Amen said during an interview at the company’s headquarters on Bristol Street near South Coast Plaza.
His practice opts for an integrated approach where patients are evaluated not only on psychology and brain images but also on biological, social and spiritual factors as well.
“We are trying to disrupt how psychological medicine is practiced,” Amen said.
Booming Psychiatry
Amen’s method is controversial; critics say it lacks scientific validity.
Nonetheless, business is booming.
The company’s up to 240 employees spread over eight clinics in the U.S., with plans to open two more facilities this year.
His first book, “Change Your Brain, Change Your Life,” published in 1999, reached The New York Times bestseller list, as have nine other of his books.
He’s consulted for the National Football League on concussion issues and advised Anaheim Ducks star Paul Kariya to retire due to concussion-related injuries.
Amen’s got the backing of Rick Warren, the best-selling author and pastor of Saddleback Church, the sixth biggest megachurch in the U.S.
Amen Chief Executive Terry Weber became a huge proponent after the clinic was able to correctly identify the condition of her eighth-grade daughter, who was previously misdiagnosed three times.
The company’s website markets Amen as “America’s most popular psychiatrist.”
Supporter
Amen, who earned a medical degree from Oral Roberts University in 1982, completed an internship and psychiatric residency training at Walter Reed Army Medical Center in Washington, D.C. while he was in the U.S. Army. He was later trained as a radiologist and X-ray technician.
“If you have a joint problem, you look at the joint—how do you know [what the problem is] if you don’t look?” said Amen, pointing out his field is “the only specialty that doesn’t look at the organ it treats.”
He uses single-photon emission computed tomography, also known as SPECT, to generate 3D colored pictures of the brain based on blood flow or chemical reactions in different areas of the brain.
Amen said the scans show “areas of your brain that work well, areas that work too hard, and areas that don’t work hard enough,” providing a window for understanding what is going on with the brain.
He said his company has the world’s largest database of functional brain scans relating to behavior, totaling over 150,000 scans on patients from 130 countries.
A treatment comprises more than medication; it also includes coaching, nutrition, hormone replacement therapy and ketamine injection therapy. He has his own line of vitamins and dietary supplements, which are also available for purchase.
American Favorite
Opponents of Amen doubt that the scans improve accuracy of diagnosis and treatment outcome.
The Washington Post published an article in 2012 with the headline: “Daniel Amen is the most popular psychiatrist in America. To most researchers and scientists, that’s a very bad thing.”
The doubting Thomases include insurance companies, most of which don’t provide reimbursements. A clinical policy bulletin from Aetna Inc. said SPECT was considered to be “experimental and investigational for all noncardiac indications.” That applies to diagnosis or assessment of attention deficit/hyperactivity disorder, autism, personality disorders, schizophrenia and suspected dementia—conditions that the clinics treat.
Amen Clinics charge $3,250 for a comprehensive evaluation, which includes a review of the patient’s medical history, two SPECT scans, a physician consultation and a 30-minute treatment follow-up appointment.
Even though SPECT has not been scientifically validated for psychiatric diagnosis in most medical circles, Weber defended the program, citing her own daughter’s experience.
“She was this 13-year-old who had no idea why she was failing at school,” Weber said. “The educational specialist suggested it was learning issues, the doctor wanted her started on Ritalin and the school system told us she wasn’t trying.”
Ritalin is a common brand name prescription used to treat attention deficit hyperactivity disorders. Possible side effects include irregular heartbeat, panic, psychosis and paranoia.
Weber said Amen Clinics scanned her daughter and provided a clear diagnosis of the “ring of fire” attention deficit disorder, or ADD, pattern—this specific type of ADD is distinguished by overall hyperactive brain activity. It is described as the most intense of the seven types of ADD. Symptoms include obsessiveness, mood instability and hypersensitivity to the environment, according to the clinic’s website.
“We left with a clear diagnosis, supplements to calm her brain, and dietary changes that could make a difference,” Weber said, adding that her daughter will graduate in May from Chapman University on the dean’s list.
After her daughter’s treatment, the veteran executive joined Amen Clinics in 2015.
Beyond Illness
It’s common to misdiagnose ADD, Amen said.
His clinics typically include patients who have had more than four failed diagnoses, changed three or four mental health professionals and put on upwards of five medications.
He pointed out there is enough understanding as to which part of the brain does what—for example, post-traumatic stress disorder symptoms typically affect the hippocampus, which has to do with memory and emotion.
He said brain images alone do not provide actual diagnosis; the images are placed in context along with other factors such as a patient’s medical history, overall health, relationships with family and friends and any history of brain injury.
The clinics emphasize “brain health” by tackling issues such as marital problems, sleep disorders, school-related problems and to a lesser degree, weight loss.
Weber said the most prevalent conditions for its clinics are trauma, anxiety, depression and attention deficit/hyperactivity disorder.
About 10% of the work in Orange County is related to memory issues such as Alzheimer’s disease.
Weber was brought on to “get the message out and continue growing nationally,” she said.
Marketing and outreach is central to the clinic’s growth, given its services are predominantly private pay. Weber said it will continue to grow its headquarters, which already employs over 100.
She anticipates hiring “more creatives,” such as social media and online marketing talents.
It has added two additional clinics since 2016, with the most recent location in Encino.
The two planned sites this year will be in Dallas and Miami, Amen said.
“Texas, for whatever reason is our top referral state,” he said, adding that the Miami clinic will see many patients from South America.
He declined to provide revenue, but said that the company has no outside funding.
Warren Backing
Saddleback Church Pastor Warren is a fan.
Amen, along with Dr. Mark Hyman and Mehmet Oz, were the doctors who contributed to the church’s “Daniel Plan,” a 52-week program designed to provide “tools and resources to help you transform in body, mind and soul,” according to the church’s website.
It was named the Christian Book of the Year in 2015.
The program helped Saddleback Church’s members lose over 250,000 pounds, according to Amen’s LinkedIn profile.
“We believe brain health is central to all health and success,” Amen said. “The industry standard 15-minute med check is not practical, [it] merely gives you more meds to counter the side effect of the [earlier] meds.”
