AMEN CLINICS METHOD FOR BOOSTING YOUR MIND, MOOD, AND MEANINGSTOP FLYINGBLINDSTART FEELINGBETTERDANIEL G. AMEN, MD
STOP FLYINGBLINDSTART FEELINGBETTER AMEN CLINICS METHOD FOR BOOSTING YOUR MIND, MOOD, AND MEANING DANIEL G. AMEN, M.D.
MEDICAL DISCLAIMERThe information presented in this book is the result of years of practical experienceand clinical research by the author. The information here, by necessity, is of ageneral nature and not a subsitute for an evaluation or treatment by a competentmedical specialist. if you believe you are in need of medical interventions, pleasesee a medical practitioner as soon as possible. The stories in this book are true.The names and circumstances of the stories have been changed to protect theanonymity of patients. Copyright © 2015 by Daniel G. Amen, M.D. All rights reserved.
This book is dedicated to all the people and families who have trusted their care to Amen Clinics.
INTRODUCTIONIn this short book you will find the Amen Clinics Methodfor helping our patients who struggle with ADHD, anxiety,depression, addictions, and more. It was developed overthe last 4 decades and has helped tens of thousands ofpeople from all over the world, from 9 months old to over100 years of age. We believe it represents a true paradigmshift in mental health care.The underlying message is that you are not stuck withthe brain you have, you can make it better. But first, it iscritical to look at the brain; At Amen Clinics we use a brainmapping study called SPECT (single photon emissioncomputed tomography), which looks at blood flow andactivity patterns.You’ve heard that an image is worth a thousand words. Buta map is worth a thousand images. A map tells you whereyou are and how to get to where you want to go. Withoutthis information in psychiatry, clinicians are literally flyingblind, which can hurt the people they are trying to help.Our work with SPECT and brain mapping has completelychanged the way we practice, and has deeply informed ourmethod. My hope is that this little book will inspire you tocare deeply about your brain. 1
MAVERICKBEGINNINGSHOW IT BEGAN “H ow do you know unlessI am the middle sibling of you look?”seven children. Growingup, my father called me amaverick, which to him wasNOT a good thing.1972... In 1972 the Army called my number and I was trained as2 an infantry medic, where my love of medicine was born. After realizing I truly hated sleeping in the mud or the thought of being shot at, I was retrained as an x-ray technician, and developed a passion for medical imaging. As our professors used to say, “How do you know unless you look?”
1979... In 1979 when I was a second year medicalI fell in student, someone in mylove with family became seriouslypsychiatry suicidal and I took her tobecause it has see a wonderful psychiatrist.the potential I came to realize that if heto change helped her, which he did,generations it would not only save herof people. life, but it could also help her children, and even her future grandchildren, as they would be shaped by someone who was happier and more stable. I fell in love with psychiatry because it has the potential to change generations of people. 3
1991...Fast forward to 1991, when lecture my two professionalI attended my first lecture loves, medical imagingon brain SPECT imaging. and psychiatry, cameSPECT shows blood flow together and quite honestlyand activity patterns in revolutionized my life.the brain. It looks at how Over the next 23 years myyour brain works. SPECT colleagues and I would buildwas presented as a tool the world’s largest databasethat could give us more of brain scans related toinformation to help our behavior on patients frompsychiatric patients. In that over 111 countries.4
WHAT CANSPECT TELL US? Full, even, Areas of increasedsymmetrical activity activityHEALTHY it’s the shape that matters.SCANS In the image on the right, red indicates the areasSPECT basically tells us of increased activity. In athree things about brain healthy scan, the back partfunction: good activity, too of the brain is typically thelittle activity or too much most active.activity. Here is a healthyset of SPECT scans. Theimage on the left shows full,even, symmetrical activity.The color is not important; 5
WHAT CANSPECT TELL US?HEALTHY STROKE VICTIMHere is a healthy scan compared to someone who had 2 strokes. Can you see the holes of inactivity?HEALTHY ALZHEIMER’S This scan shows deterioration in the back half of the brain of an Alzheimer’s patient. Did you know that Alzheimer’s starts decades before you have any symptoms?6
HEALTHY TRAUMATIC BRAIN INJURYTraumatic brain injury — your brain is very soft and your skull is very hard.HEALTHY DRUG ABUSEThe real reason not to use drugs is because they damage your brain. 7
WHAT CANSPECT TELL US?HEALTHY OCDObsessive compulsive disorder (OCD) typically has too much activity in the front part of the brain, which is why people have trouble turning off their thoughts.HEALTHY SEIZURE ACTIVITY With epilepsy we often see focal areas of increased activity.8
SPECT:MAKING ADIFFERENCE1992... In 1992 I attended an all- day lecture at the American Psychiatric Association on brain SPECT imaging in psychiatry given by physicians at Creighton University. It was amazing and mirrored my own early experience. Yet, at the same conference, researchers complained loudly that clinical psychiatrists SHOULD NOT be using the scans; they were only for their research. Being a maverick and someone who had personal experience using scans, I knew that position was dead wrong! Without imaging, psychiatrists still made diagnoses 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. 9
SALLY SALLYAT REST CONCENTRATINGSPECT: MAKING ADIFFERENCE In the first 50 cases I a frequent tip off that one ordered SPECT scans, of the parents has ADD. they made a dramatic Plus, she was restless and positive difference for pretty impulsive. When I my patients. Here are talked to her about ADD some examples: she didn’t think it applied to her because she could Sally, 44, was admitted concentrate if she was really to the hospital for suicidal interested. So I decided thoughts after a fight with to scan Sally at rest, and her husband. As I got to again while she performed know her, I thought she had a concentration task. At rest ADD. She dropped out of Sally had a healthy looking college, despite having an brain, but when she tried IQ of 144, and she had a to concentrate her brain hyperactive son, which is really dropped in activity, especially in the front!10
When I laid the pictures on can focus. In fact, as youthe table in her hospital room can see, the harder you tryand explained them to her the worse it gets.”she started to cry and said,“You mean it’s not my fault?” This helped Sally make sense of her life and she had“Right,” I said, taking the a wonderful response to theglasses I wear to drive out treatment. She felt calmer,of my pocket. “Having ADD more focused, went backis just like people who need to school and finished herglasses. People who wear degree. The relationshipsglasses aren’t dumb, crazy with her husband and sonor stupid. Our eye balls are were better and she noshaped funny and we wear longer thought of herself as aglasses to focus. Likewise, failure, but as someone whopeople who have ADD aren’t needed help for a medicaldumb, crazy or stupid. Their problem. The SPECT imagesfrontal lobes shut down made a radical change in herwhen they’re supposed to attitude toward herself andturn on. They need help to her treatment.turn them back on so theyChris, 12, was hospitalized Chris’s scan showedfor the third time for violent low activity in his leftoutbursts, and his treatmentof multiple medications and temporal lobetherapists had failed. At AmenClinics, his scan showed lowactivity in his left temporallobe, a part of the brainimplicated in seizures andviolence. On an anti-seizuremedication, his aggressiveoutbursts stopped. 11
SPECT: MAKING ADIFFERENCEMatilda, 69, wasdiagnosed with Alzheimer’sdisease, but she didn’thave the Alzheimer’sSPECT pattern. Her scanwas more consistentwith depression and hermemory was restored on amedicine for depression. MATILDA’S SCAN KEN’S KEN’S SCANBEFORE SCAN ONE YEAR LATER Ken, 44, was abusing alcohol and cocaine, but was in denial about it. After seeing his “toxic” scan he completely stopped the abuse. A year later Ken and his brain scan were better.12
Do you know that psychiatrists are theonly medical specialists who rarely lookat the organ they treat?Think about it. Cardiologists look,neurologists look, orthopedists look.In fact all other medical specialistslook. Psychiatrists guess.Pulmonologists Gastroenterologists Obstetricians look...look... look...Cardiologists Every other medical specialist looks... look... at Amen Clinics, we look too. 13
Before imaging,I was throwing dartsin the dark and hadunintentionallyhurt patients, whichhorrified me.14
15
LESSONSLEARNED FROMBRAIN SPECTIMAGING Two patients with the same Early on, SPECT taught us symptoms. Treatment needs to be many important lessons. The first one was that problems like tailored to individual brains. ADD, anxiety, depression and16 addictions are NOT single or simple disorders in the brain; they all have multiple types. To the left are scans of two people with depression who have virtually the same symptoms, but radically different brains. One has low activity; the other high activity. Do you think they’ll respond to the same treatment? Of course not! Treatment needs to be tailored to individual brains, not a cluster of symptoms. And how would you ever know unless you actually looked? The current method by which almost all psychiatric patients are diagnosed is with symptom clusters according to a document called the DSM (Diagnostic and Statistical Manual V5).
If your symptoms cluster disorder or I.E.D. and no onearound depression you get is quite sure what to do.a diagnosis called majordepression and typically an Unfortunately, this symptomantidepressant is prescribed. cluster based approach tellsOr, if you have a cluster of you nothing about what isanxiety symptoms, you are going on in someone’s braingiven an anxiety disorder and psychiatric outcomesdiagnosis and typically have not improved in over 50prescribed anti-anxiety years. We can do better, butmedication. we have to look at the brains of our patients and tailor theIf you have attention and treatment to the symptomimpulse control problems, clusters together with whatyou receive an ADD or ADHD we see on scans. This is onediagnosis and are prescribed of the big contributions Amenstimulant medication. Clinics has been making to the field of psychiatry.My favorite diagnosis todescribe this phenomenon is Effective treatment needsif you explode intermittently to be tailored to individualyou are given a diagnosis brains, not a cluster ofcalled intermittent explosive symptoms.CURRENT WAY MOST AREDIAGNOSED AND TREATED:SYMPTOM DIAGNOSIS TREATMENT“I AM DEPRESSED.” “YOU ARE DEPRESSED.” Anti-Depressants Anti-Anxiety Meds “I AM ANXIOUS.” “YOU ARE ANXIOUS.” Stimulants Anger Management“I AM UNFOCUSED.” “YOU HAVE ADHD.” Meds “I EXPLODE “YOU HAVE INTERMITTENT INTERMITTENTLY.” EXPLOSIVE DISORDER (IED).” * There is a reason that most psychiatric medications have black box warnings. If you give them to the wrong person you can precipitate a disaster. 17
MILD TRAUMATIC BRAININJURIESThe second lesson was not just more medication orthat mild traumatic brain behavior therapy.injuries are a major cause of Research has shown us thatpsychiatric illness and ruin undiagnosed brain injuries arepeople’s lives. Few people a major cause of depression,know about it because only panic attacks, drug anda handful of mental health alcohol abuse, homelessness,professionals ever look at ADHD and suicide.the brains of their patients. The enduring effects ofHere’s a SPECT scan of a traumatic brain injuries.15-year-old boy who felldown a flight of stairs atthe age of 3. Even thoughhe was unconscious foronly a few minutes and wasgiven a diagnosis of mildtraumatic brain injury, therewas NOTHING mild aboutthe enduring effect the injuryhad on his life. I met himafter he had been kickedout of his third residentialtreatment program forviolence. He needed abrain rehabilitation program, Undiagnosed brain injuries are a major cause of depression, panic attacks, drug and alcohol abuse, homelessness, ADHD and suicide.18
TOXIC EXPOSURE ORINFECTIOUS DISEASE Another causes of her symptoms, important such as an infection or lesson was that toxicity. It turned out Adrianna unrecognized had Lyme Disease, a bacterial toxic exposure infection often caused by or infectious deer ticks. Once she took disease is a antibiotics, Adrianna got her common cause life back.of psychiatric symptoms.Adrianna was normal until the 19age of 16 when she went ona mountain vacation with herfamily. When they arrived atthe cabin near Yosemite, theywere surrounded by 6 deer.It was a beautiful moment.Ten days later, Adriannabecame agitated and startedhaving auditory hallucinations.Her family brought her to apsychiatrist who diagnosedher as psychotic andprescribed medications,which didn’t help. The next 3months were a torturous roadof different doctors, multiplemedications and a cost ofnearly $100,000. Adriannahad become a shadow ofher former self. Adrianna’sparents brought her for ascan, which showed areasof unusually high activity.It caused our physician tolook deeper at the potential
SOME PRESCRIPTION MEDSCAN BE TOXICAnother critical lesson When I ordered my first fewwas that many psychiatric scans for patients on thesemedications had the potential medications they looked liketo be toxic for brain function. they were alcoholics, so IWhen I did my psychiatric stopped using them. That’straining at the Walter Reed when I really got seriousArmy Medical Center, we about using natural wayswere taught to use a class of to heal the brain, includinganti-anxiety medication called hypnosis, meditation andbenzodiazepines. nutritional supplements. HEALTHY BENZODIAZEPINES20
NOT LOOKING AT THE BRAINHURTS PATIENTS AND FAMILIES►► Symptom based ►► Marital problems are diagnoses can be often mislabeled as misleading. psychological when With many roads leading they may be brain to psychiatric disorders, related. Marital therapists symptoms tell nothing of have no training in the underlying physiology. neuroscience and aren’t Physicians often make looking at the full picture. mistakes by calming underactive brains or ►► A huge opportunity stimulating overactive is often missed to ones. decrease stigma, increase treatment►► One-size-fits-all compliance and create treatments often fail. the desire, known as brain Each person is uniquely envy, for healthy brains different and requires and lives. personalized targeted treatment. 21►► There’s no understanding of illness subtypes. Most disorders have multiple subtypes. It’s important to find your subtype for the correct treatment.►► Physicians often miss traumatic brain injury, toxicity and infections which are frequently the primary cause of psychiatric symptoms.►► Physicians often miss the fact that some psychiatric medications are toxic.
NOT LOOKING AT THE BRAINHURTS OUR SOCIETY►► Organizations like the ►► Military personnel NFL/NHL remained with TBI are often left in denial for decades without appropriate about the long term help and hope. effects of traumatic How do you know if a brain injury (TBI). TBI was significant unless Functional brain imaging you actually look at brain tools changed everything. function? ►► Costly dementias are not diagnosed until late in the illness. Even though it starts in the brain decades before any symptoms appear, no prevention or early treatment can occur. ►► Violent behavior is never truly rehabilitated because people are only judged morally, and not treated medically. This is like doing software programming on people who have hardware problems.22
PUBLISHED OVER 60 PEER-REVIEWED SCIENTIFIC ARTICLES As we continued our work with SPECT, the criticism from researchers GREW LOUDER… “Why doesn’t he publish his research?”, they cried. I asked if they knew how to read. Since 1993, my colleagues and I have continually published research, now numbering over 60 peer reviewed articles*, and I’ve presented at many medical conferences, including at the American Psychiatric Association, Biological Psychiatry, American Association of Neuropsychiatry, and the National Science Foundation. * See references at the end. 23
EVEN AS THE CRITICISMCONTINUED, SO DID THE LESSONSIf you don’t admit you have were still studying the issue.”a problem, you cannot do The problem with the NFLanything to solve it. The position was that if you do notNFL formed its concussion admit you have a problem,committee in 1994, but over you cannot do anything tothe next 20 years never solve it. Many brain damagedsponsored a functional brain NFL players were left withoutimaging study on players. help or hope.Instead they studied rats.They actually put little helmets From 2009 to 2012, Amenon the rodents and repeatedly Clinics, together with thehit them in the head with LA chapter of the NFLmetal pellets. Retired Players Association, performed the first and largestIn 2009, Commissioner functional brain imaging studyGoodell said to Congress, on active and retired players.“The NFL didn’t know if Brain SPECT helped toplaying football caused long- change everything.term brain damage. They24
In our SPECTresearch publishedin the Journal ofNeuropsychiatry, wedemonstrated highlevels of brain damagein players.That was not asurprise. Purple equals areas of low activity. 25
Here is a healthy SPECT scancompared to one of our players who was a 16 year NFL veteran:HEALTHY 16 YEAR NFL GUARD What really excited us was that while on the Amen Clinics Method, 80% of our players showed significant levels of improvement, especially in the areas of blood flow, mood and memory.26
80% of the playersshowed improvementTHE SAME PLAYER A YEAR LATER, MUCH BETTER. 27
INEFFECTIVE TREATMENT ISVERY EXPENSIVESome people complain about ►► Underachievement,the cost of an evaluation demoralization — notwith SPECT scans, but they living up to your potentialoften forget to compare is costly and decreasesthe cost to ineffective tax revenue!treatment, which can beVERY expensive. Because ►► School failure — failedof the wrong diagnosis or college attempts aretreatment plan, people spend costly!thousands of dollars on thewrong medications, hospital ►► Job failure —stays, residential treatment multiple job changes,programs, and divorce or absenteeism, and beingcriminal attorneys. Also, fired is expensive!school failure, job failure andunderachievement are very ►► Relationship problemsexpensive. Seen in this light, — divorce is veryour evaluations and treatment expensive!plans are usually very costeffective, as they are targeted ►► Legal problems —to your brain. lawyers are expensive! Effective ►► Failed therapy attempts. treatment can help you feel ►► Multiple failed better quickly. medication trials with side effects cost a lot. ►► Residential treatment can cost about $100,000 a year. ►► 28-day drug treatment can run from $20,000 to $80,000 a month. ►► Psychiatric hospital stays can exceed $2,000 a day.28
$$$ LEGAL FAILURE INJOB PROBLEMS SCHOOLFAILURE demoralization DIVORCEMULTIPLE MEDICATION TRIALSPSYCHIATRIC TROUBLED RELATIONSHIPSHOSPITAL STAYS MPTS$2,000/DAY APY ATTE LED THER FAI 29
CHANGINGPEOPLE’S BRAINSAND LIVESBETTER BRAIN,BETTER LIFE.After nearly 100,000 brain Here is the scan of anSPECT scans over the past 3 ADD teenager who haddecades, the most important been cutting herself, failinglesson we’ve learned is in school and fighting withthat we can literally change her parents. On treatment,people’s brains and their lives. the low activity in her brain became much better andYou are not stuck with the she went from Ds and Fs tobrain you have — we can As and Bs and was morehelp you make it better. emotionally stable. ADD TEENAGER AFTER BEFORE TREATMENT30
Here is Nancy’s scan who was diagnosed with dementia. The doctor told her husband that he should find a home for her because in a year she would not know his name. After 10 weeks on an intensive brain rehabilitation program, Nancy’s brain was better, her memory was improved and 5 years later she still knows her husband’s name.NANCY BEFORE AFTER TREATMENT 10 WEEKS 31
CHANGINGPEOPLE’S BRAINSAND LIVES ANDREW’S STORY. My favorite story is of Andrew, a 9-year-old boy, who attacked a little girl on the baseball field for no particular reason and 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 him, as they did with Eric Harris and the other shooters before their shocking crimes, however our imaging work taught us to first look at his brain to better target what he needed. Large cyst was evident in the left temporal lobe, an area often implicated in violence.32
His SPECT scan showed Now, 18 years later, Andrew,a cyst the size of a golf who is my nephew, isball occupying the space employed, owns his ownof his left temporal lobe, home and is a happy, lovingan area often implicated human being. Becausein violence. No amount of someone looked at his brain,therapy or medication would he has been a better son,have helped Andrew. When and will be a better husband,the cyst was removed, his father and grandfather.behavior went COMPLETELYback to normal and he wasonce again the sweet lovingboy he always wanted to be. 33
THE AMENCLINICS METHODA true paradigm shift in Brain HealthThe Amen Clinics Method The Amen Clinics Methodrepresents a true paradigm gives our physicians a deepshift in optimizing and healing understanding to targetthe brain. We believe it is treatment specifically tailoredcritical to look at your brain to your brain and situation.within the context of your life. In studying our outcomes on ►► Looking at specific more than 2,000 patients, biological, psychological, the Amen Clinics Method social, and spiritual has proven very successful influences for many and we have some of the best outcome results ►► Neuropsychological anywhere, even for people testing who have been labeled as complicated or treatment ►► Brain SPECT imaging resistant. at rest and during concentration ►► Lab tests (when necessary)34
CURRENT PSYCHIATRY NEEDS IMPROVEMENT... “I feel “You suffer fromdepressed.” depression. Here is an antidepressant.”... WITH A NEW APPROACH AMEN CLINICS “I feel “We need more METHODdepressed.” information”THE PROBLEMWe need to do betterToday, psychiatry is practiced see if he or she got it right.by many physicians the Many times patients willsame way it was 60 years get multiple diagnoses andago: A doctor assesses prescriptions before they findyour symptoms, forms a relief — if at all. Treatmentdiagnosis based on those success rates have notreported symptoms, and improved in decades, eventhen prescribes a medication though technology andat a dosage that may or science have progressedmay not work. From there, dramatically.it’s a matter of watching to 35
AMEN CLINICSMETHOD STAGE 1: Assess Detailed Personal History At Amen Clinics, we see the condition of every patient as a result of four primary factors, or circles, all of which can have a meaningful impact on mental health: your biology, psychology, social life, and spiritual life. We have designed our intake process to look at each of these circles. This allows us to truly understand you.36
ASSESS THE 374 CIRCLES OFBRAIN HEALTHBIOLOGICALWe want to know about your genetics,overall health, diet, exercise, and any historyof brain injury or exposure to toxins.PSYCHOLOGICALWe’ll explore your thinking patterns and askif you had any significant developmentalevents or emotional traumas in the past.SOCIALWe’ll ask what your relationships withfriends and family are like, if you have alot of stressors and if you spend time withothers or feel isolated.SPIRITUALWe want to know why you care, what’simportant to you and what gives you asense of meaning and purpose in life.
STAGE 2:Evaluate Brain Activity, Function& ChemistrySPECT images tell us three How can weimportant things: know what is going on with ►► Areas of the brain that your brain work well unless we look? ►► Areas of the brain that don’t work hard enough ►► Areas of the brain that work too hardSPECT images provideextremely valuable insight:They connect the dotsbetween your brain function,behaviors and symptoms,which helps our doctorscreate an individualizedtreatment plan that iseffectively targeted to meetyour needs. REST CONCENTRATION38
KNOW YOUR NEURO-IMPORTANT PSYCHOLOGICALNUMBERS TESTINGYour biological state plays a We use 2 neuropsychologicalpowerful role in your mental tests to give us additionalhealth. For instance, if your details about how your brainhormones are out of balance, is working.your mood and mental The Conners Continuousclarity will be out of balance Performance Test-II helpstoo —and no amount of to assess focus, responseantidepressants or stimulants speed and impulse control.are going to help. WebNeuro measures domains of function inIf deemed appropriate, we thinking, feeling, emotion, andwill order a set of diagnostic self-regulation; including testslab tests to measure your for mood, anxiety, attention,basic health numbers, and memory.and depending on thecircumstances, we may also 39order genetic markers ormore extensive testing.
STAGE 3: Targeted and Personalized Care Plan At the Amen Clinics, we understand that no two people are alike, and treatment is not one-size-fits- all, especially in psychiatry. With a complete picture of your biological, psychological, social and spiritual health, together with SPECT imaging, neuropsychological tests and labs (when appropriate), our doctors will provide you with a personalized, targeted treatment plan geared toward your symptoms and your brain. Based on your needs and desires, your plan may include a combination of different treatments such as: ►► Key lifestyle changes ►► Dietary interventions ►► Nutritional supplements ►► Medication ►► Targeted psychotherapy ►► Exercise (brain & physical)… and more40
High Published Success RatesLeast Toxic, Most During the last 23 years,Effective Solutions we have performed nearly 100,000 brain SPECTDid you know that some scans on patients from 111psychiatric medications countries and have seen howare actually toxic for brain carefully made diagnosesfunction? As we formulate and targeted personalizedindividual treatment plans, treatment can literally andour doctors follow a simple dramatically change people’sguiding precept: Find lives.solutions that will treat thecondition most effectively Recently, our experience waswhile imposing the least clinically confirmed in a majorpossible toxicity. study involving more than 500 patients from the AmenWe offer many natural Clinics:therapies and robust supportfor patients as they make ►► After 6 months ofbrain-healthy life changes. treatment, 77% of theseWhere medication is indicated patients were betterand appropriate, Amen across all measures.Clinics’ doctors are able toprescribe them. ►► 85% reported having a better quality of life. ►► And the results were even higher when the patients carefully followed their treatment plan! 41
DEVELOP “BRAIN ENVY3 simple principles will boostyour brain health.1. CAREYou need to care aboutyour brain health.“Brain Envy” is the strongdesire to have a better brain.It means wanting to protect,nourish and focus on yourbrain’s health. Falling in lovewith your brain is the firststep to becoming healthier,smarter and happier.“My last scan, at age 52, looks healthier and younger than my first scan, even though brains typically become less active with age. Why? Seeing other people’s scans, I developed ‘brain envy’ and wanted mine to be better. — Actual Amen Clinics Patient 43
2. AVOID Avoid anything that hurts your brain.►► Brain injuries ►► Drugs & alcohol►► Obesity ►► Lack of activity►► Insomnia/apnea ►► Poor diet►► Nicotine/caffeine ►► Low omega 3s►► Environmental toxins ►► Low hormones►► Emotional trauma ►► Chronic stress►► Unhealthy peer group ►► Poor decisions►► Not knowing your own ►► Diabetes ►► High blood pressure brain’s vulnerability44
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