Image Credit:  americanhealthimaging.com

people who do bad things have troubled brains

"As we continued our work with SPECT, the criticism grew louder, but so did the lessons. Judges and defense attorneys sought our help to understand criminal behavior. To date we have scanned over 500 convicted felons including 90 murderers. Our work taught us that people who do bad things often have troubled brains. That was not a surprise.

"But what did surprise us was that many of these brains could be rehabilitated."

                                                                                                                                                      ----Dr. Daniel Amen
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Excerpts
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Psychiatrists Behind The Times

Without imaging, psychiatrists then and even now make diagnosis like they did in 1840, when Abraham Lincoln was depressed, by talking to people and looking for symptom clusters. Imaging was showing us there was a better way.

Did you know that psychiatrists are the only medical specialists that virtually never look at the organ they treat? Think about it. Cardiologists look, neurologists look, orthopedic doctors look, virtually every other medical specialties look — psychiatrists guess.

. . .

Before imaging, I always felt like I was throwing darts in the dark at my patients and had hurt some of them which horrified me. There is a reason that most psychiatric medications have black box warnings. Give them to the wrong person, and you can precipitate a disaster.

Mental Illness More Complicated than We Are Treating It

Early on, our imaging work taught us many important lessons, such as illnesses, like ADHD, anxiety, depression, and addictions, are not simple or single disorders in the brain, they all have multiple types. For example, here are two patients who have been diagnosed with major depression, that had virtually the same symptoms, yet radically different brains.

One had really low activity in the brain, the other one had really high activity.

How would you ever know what to do for them, unless you actually looked? Treatment needs to be tailored to individual brains, not clusters of symptoms.

Brain Injury

Here’s a scan of a 15-year-old boy who fell down a flight of stairs at the age of three. Even though he was unconscious for only a few minutes, there was nothing mild about the enduring effect that injury had on this boy’s life. When I met him at the age of 15, he had just been kicked out of his third residential treatment program for violence.

He needed a brain rehabilitation program, not just more medication thrown at him in the dark, or behavioral therapy which, if you think about it, is really cruel. To put him on a behavioral therapy program when behavior is really an expression of the problem, it’s not the problem.

​Researchers have found that undiagnosed brain injuries are a major cause of homelessness, drug and alcohol abuse, depression, panic attacks, ADHD, and suicide. We are in for a pending disaster with the hundreds and thousands of soldiers coming back from Iraq and Afghanistan, and virtually no one is looking at the function of their brain.
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Transcript

So here’s a radical idea. What if we evaluated and treated troubled brains rather than simply warehousing them in toxic, stressful environments? In my experience, we could save tremendous amounts of money by making these people more functional, so when they left prison, they could work, support their families and pay taxes.

Dostoyevsky once said: “A society should be judged not by how well it treats its outstanding citizens, but by how it treats its criminals.” Instead of just crime and punishment, we should be thinking about crime evaluation and treatment.

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Brain Cyst

[M]y favorite story to illustrate this point is Andrew, a 9-year-old boy who attacked a little girl on the baseball field for no particular reason, and at the time, was drawing pictures of himself hanging from a tree and shooting other children. Andrew was Columbine, Aurora, and Sandy Hook waiting to happen. Most psychiatrists would have medicated Andrew, as they did Eric Harris and the other mass shooters before they committed their awful crimes.

But SPECT imaging taught me that I had to look at his brain and not throw darts in the dark at him to understand what he needed. His SPECT scan showed a cyst, the size of a golf ball, occupying the space of his left temple lobe. No amount of medication or therapy would have helped Andrew.

When the cyst was removed, his behavior completely went back to normal, and he became the sweet, loving boy he always wanted to be.

Now 18 years later, Andrew, who is my nephew, owns his own home, is employed and pays taxes.

​Because someone bothered to look at his brain, he has been a better son, and will be a better husband, father, and grandfather. When you have the privilege of changing someone’s brain, you not only change his or her life but you have the opportunity to change generations to come.

Brain Scans as a means to reveal biomarkers for suicidal risk

[According to current research, Mass shooters are often actively suicidal]

​NPR - Aug. 6, 2019

​Peterson has interviewed living mass shooters in prison and people who knew such perpetrators and has found that these individuals often start out feeling suicidal.

"We can show about 80 percent were actively suicidal prior to the shooting," she says.

Now, the vast majority of people who are suicidal don't attack others. And people with any kind of mental health problems aren't more likely to be violent than others. In fact, they are more likely to be victims of violence than those without mental illness.

But Peterson says that in very rare cases, a tiny minority of people considering suicide go down the path of violence toward others. She has come to think of mass shootings as a form of suicide. "They're angry, horrible suicides that take a lot of people with them," she says.

"The shooter never intends to live; there's never a getaway plan. Typically they tend to think of this [as] their kind of last moment."

Other researchers have documented the same in studies of active shooters.

"About half of the school shooters I've studied died by suicide in their attack," Peter Langman, a clinical psychologist in Allentown, Pa., told NPR earlier this year.

"It's often a mix of severe depression and anguish and desperation driving them to end their own lives."