Dr. Daniel Amen: Happiness and good brain function

Dr. Daniel Amen, author of "Change Your Brain, Change Your Life," is a clinical neuroscientist and child and adolescent psychiatrist. He is the director of The Amen Clinic for Behavioral Medicine and is one of only a handful of psychiatrists in the world who is also licensed in nuclear brain imaging.

CNN: Good day Dr. Amen and welcome to our discussion today.

DR. AMEN: My greetings to everybody, around the world. It's very exciting for me to be here and talk about some of the work I do.

CNN: Dr. Amen, you speak of poor brain function as a cause of unhappiness. Can you explain how this occurs over time?

DR. AMEN: Your brain is involved in everything you do, how you think, how you feel, how you act, how you get along with other people. What we have learned, after doing over 12,000 brain scans is that when your brain works right, you can work right, which includes being happy. And when your brain isn't working right, it's hard for you to be the best you can be, and is frequently associated with illness such as depression.

CHAT PARTICIPANT: Does Dr. Amen recommend that ALL couples get scanned before marriage? Who should get them and who shouldn't?

DR. AMEN: Unfortunately, the technology is only available in limited areas. Having said that, when my daughter dates someone for more than four months, I start bugging her about getting him scanned. :) So, it's not practical to scan everyone you think about marrying, but you want to think about brain function. Are they someone who well help your brain function over time? Or will they put you at risk? ... for head injuries, for drug abuse, some kind of toxic exposure?

CHAT PARTICIPANT: What about people who have everything in life but are still never happy with one thing or the other...is it their attitude or some physical defect in the brain?

DR. AMEN: It's probably both. It's hard to know unless you look, and I talk to my colleagues about that all the time. If you have everything in life, and you're still unhappy, it may be your attitude, or it may be your brain. For example, you might have a hot limbic system that you inherited, and it's not your fault, and changing your attitude won't help. It may be something you need medicine for.

CHAT PARTICIPANT: How would mild traumatic brain injury affect mood and how might that be tested/ treated? Thanks!

DR. AMEN: Mild traumatic brain injury can significantly change brain function, even if you do not lose consciousness. We've found that consciousness or lack of consciousness is not really a good monitor of brain damage. So, mild injury can change brain systems that are involved in happiness, such as the prefrontal cortex, which tends to modulate mood.

CHAT PARTICIPANT: I had a heart operation, and after that I've been really sad. How can I change?

DR. AMEN: Having a heart operation, or having a heart attack or heart disease is very commonly associated with depression, much more so than most people think. In a number of studies, up to 60 percent of people with heart problems will develop a major depression within 18 months. If you have sadness that persists for 3-4 weeks after a heart attack or a heart operation, get help. What we know is that anti-depressant medication can frequently reverse the depression associated with heart disease. This is very personal for me. When I was in medical school, my grandfather had a heart attack, and became depressed, and no one had picked it up.

CHAT PARTICIPANT: Apart from physical exercise, what else can one do to improve self-motivation in order to reach our goals of happiness?

DR. AMEN: One of the first things to do is to have very clear goals. It's a prefrontal cortex function, the front part of our brain sort of supervises us and watches us and helps us with goal-setting and forethought. So, the first step to happiness is having very clear goals in your relationships, at work, and for yourself, apart from work and relationships. Once you have those goals, ask yourself every day if your behavior is getting you what you want. But first you have to know what it is you want.

CHAT PARTICIPANT: How does a person's childhood affect them? And what can we do about people who are annoying, to say the least?

DR. AMEN: Childhood has a huge impact on how we feel. I think of the mind as a combination between hardware and software. Hardware is sort of the physical functioning of your brain. Software is how we were programmed. Both are very important. It's important to have a healthy brain to be happy, but it's also important to have healthy programming, to be raised in a safe, structured, loving environment, and without those things, it can certainly have a negative impact on who you are. They can be overcome, but it's harder.

Dealing with annoying people is another issue. For me, personally, after all the brain scans I've done, I realize that many annoying people have brains that don't work right. That somehow helps me! In my book "Change your brain, change your life," I actually give tips for people on dealing with difficult people. So, for example, people who have cingulate gyrus problems tend to worry, be inflexible, be oppositional and argumentative. They are easily upset when things don't go their way. They tend to do worse on high-protein diets, and better with simple carbohydrate diets. So, if someone is really annoying you, don't feed them ham and eggs in the morning. Give them a bagel.

CNN: How costly are the brain scans that you use, and would conventional medical insurance pay for it?

DR. AMEN: The scans we use are called SPECT. We typically do two scans, a rest and a concentration scan. They are a thousand dollars apiece. Insurance often covers it if it's ordered properly, which means if we order it for medical reasons, such as brain trauma, dementia, or looking for frontal or temporal lobe problems.

CHAT PARTICIPANT: What is the measurement of happiness? When do I know that I am happy enough?

DR. AMEN: Well, that's really for you to decide. I think some people are happy if they're going to eat today, and others aren't happy until they find the perfect mate. It really depends on you, and your own personal definition of happiness. For me, personally, it's doing something I love, and I'm blessed because I do that in my work, and surrounding myself with people who I love, and who love me back.

CHAT PARTICIPANT: My girlfriend has bipolar disorder. She sees her therapist twice a week and takes her meds. Can she "change her brain, change her life"?

DR. AMEN: That's what she's doing, by taking her medicine. We know that when you take the right medicine, it optimizes brain function, and allows her access to the good working of her brain. By seeing her therapist, hopefully it helps her to optimize her thinking patterns, and how she behaves in relationships, and to bring more love into her life, such as you. So, she's likely doing the things that are helpful for her. In addition, she should avoid head injuries. If possible, avoid anything toxic, drug abuse, alcohol abuse, and she should exercise and eat right. When I talk about eating right, I often recommend Barry Sears' book, "The Zone," which is a very healthy and brain-balanced way to eat.

CHAT PARTICIPANT: Can you overcome some psychological problems by not going to psychologist?

DR. AMEN: Of course you can, if you're motivated to learn about thinking patterns and behavior patterns that bring happiness in your life. Psychologists can be very helpful, acting sort of like coaches to help you clean out the closet of your past, and put in more effective tools for winning in the present. But motivated people can learn about it on their own.

CHAT PARTICIPANT: Dr Amen, Thank you for the show. I am writing a project and I have heard that it is documented that laughter releases endorphins in the body. Can you explain the positive and negative effects laughter has? Is the answer the same for children?

DR. AMEN: That's a really wonderful question, and the short answer is that we don't really know, but it's my suspicion. I want to do a study, looking at brain function before laughter or after laughter, and see what happens. My guess is that after laughing, your brain will be more focused and happier. But I still think we need to do the studies.

CHAT PARTICPANT: What comes first: our emotions or our thoughts?

DR. AMEN: It depends. Our thoughts can generate positive and negative emotions, but sometimes we have feelings that are not connected to thoughts. So, I don't think there is a simple answer to that question, but clearly, if I sat here and thought about the plane crashing on my way back to California, that would make me have anxious emotions. Or if I thought about one of my children having a car accident, then I would start to feel anxious and sad. So, thoughts can drive emotions, but sometimes emotions happen on their own.

CHAT PARTICIPANT: Why should we welcome scans that predict our behaviours?

DR. AMEN: I don't think scans are at the point where they predict behavior, but they can predict vulnerabilities to behavior. And don't we want to know if we're vulnerable to depression, anxiety, aggression, so that we can take steps to decrease our risks for those problems? Don't we want to know if we are vulnerable to Alzheimer's disease, so we can take as many preventive measures as possible. For me personally, I want to know.

CHAT PARTIPANT: Wouldn't what is happening at the time be reflected in the scan, but not necessarily what they normally reflect? Isn't the scan just a snapshot in time?

DR. AMEN: No. The scans are actually very stable and reliable over time, they're not thrown around by the thoughts at the moment. We've scanned people nine years apart, and they're actually nearly the same. I've been scanned six times, and it's the same thing each time.

CHAT PARTICIPANT: How can you change your brain chemistry yourself to rid yourself of the terrible disease called obsessive compulsive disorder or ocd -(repetitive compulsive checking)?

DR. AMEN: OCD is a very common disorder that shows too much activity in certain parts of the brain. What we have found is that both medication and behavior therapy can have a very positive impact on the brain and on the disorder. So, whatever it is that you might have, whether OCD, depression, ADHD, or bi-polar disorder, it is very important to learn as much about it as possible, and take steps to balance both your brain, and your thoughts and behavior.

CNN: Do you have any final thoughts for us today?

DR. AMEN: I want people to think about their brain, and think about keeping them healthy. I had a patient recently, a cabinetmaker. He spent his days inside with cabinets, but also with toxic fumes, varnishes, paints, things like that. When we scanned his brain, because of problems with relationships, we found toxic problems. No one had thought about that. We found that he needed better ventilation.

The brain controls everything you do. Be sure to check our Web site at brainplace.com where you can see 300 color SPECT images, take a brain system test, and put together a brain puzzle. It's a fun, educational site.

CNN: Thanks for joining us today, Dr. Amen!

DR. AMEN: Thank you so much for having me.

Dr. Daniel Amen joined CNN.com chat room from CNN Center in Atlanta, GA. CNN provided a typist for him. The above is an edited transcript of the interview on Sunday, September 09, 2001.