Feb 1, 2017
Dr. Daniel Emina is a child/adolescent and adult psychiatrist who earned his medical degree from the University of California Los Angeles School of Medicine, and completed his general residency in psychiatry and child/adolescent fellowship at the University of Hawaii Department of Psychiatry. His training was modeled on a bio/psych/social/spiritual/cultural understanding of an individual and featured a diverse patient population.
In this brief interview, we'll get to know Dr. Emina's three most important lessons he has learned while working at the Amen Clinic.
Dr. Amen: Hey everybody. Dr. Daniel Amen. I'm here with Dr. Daniel Emina.
Dr. Emina: Two Daniels.
Dr. Amen: We are here in our Northern California Clinic in Walnut Creek. We are going to talk about the three biggest lessons that Daniel who has worked with us for the last two and a half years has learned working at Amen Clinics. Daniel is double board certified psychiatrist. He trained at UCLA and at the University of Hawaii. You know I did my child psychiatry training at Tripler along with University of Hawaii. In both of our psychiatric training they never taught us to look at the brain. Isn't that nuts? When you think about it, it's nuts. When you think after being here two and half years, what are some of the big lessons you've learned? What comes to mind?
Dr. Emina: First thing is, I think I'm extremely spoiled being here. It's drastically changed the way I understand mental health. I don't even think of it as mental health anymore, I think of it as brain health. I think that almost everyone should come in and start to think of how can I make my brain better? No matter what diagnosis you may have had before, I usually start to think well, don't think of it like that, just think of it as how can I optimize my brain? You could come in and be a CEO of a company doing extremely well technically in life but there's things you can always do to optimize your brain. Lesson one for me is it's not really mental health anymore. I'm not necessarily a mental health doctor now, I'm a brain health doctor now.
Dr. Amen: So whether it's ADD, anxiety, depression, bipolar disorder and addictions, schizophrenia, or you're fighting with your wife or you're irritable with your kids-
Dr. Emina: Or don't sleep as well or you just want to be even better at the tasks you do everyday, whatever that may be at home, at work, whatever it may be because ultimately it's your brain that controls everything you do.
Dr. Amen: Okay so you see mental health as brain health. I think that's like a huge 'aha' for me. I've learned nobody really wants to see a psychiatrist. Nobody wants to be labeled as defective or abnormal but everybody wants a better brain. Nobody would argue with you, "No I don't want a better brain." They do. It decreases the stigma which is one of the things that hooked me early on with scans is patient stops thinking of it as a moral problem, as a problem of not trying hard enough, but as a medical problem.
Dr. Emina: Yes. I should add that as being my second biggest thing in some ways. I've been so spoiled to have this tool. I'm trying to imagine not having this tool, practicing without this tool. It completely changes the way I see clients as they come in with whatever concern they may have. Even concerns related to people who have been labeled as personality disorders and things like that. Now you get to see what they were trying to deal with all this time. A lot of our coping mechanisms whether good or maladaptive, a bad coping strategy, are based on how we try to manage that brain we have. Lesson number two for me, the biggest was, you have to look at the organ you're treating. I'm trying to imagine if, you definitely talked about this, if I'm a cardiologist I have to kind of imagine, well based on what you're telling me potentially this is what's going on with your heart. This has completely changed the way I understand clients.
Dr. Amen: Not acceptable. It's just not acceptable. I remember working on a new book and writing about chronic fatigue syndrome and back in the early '90s when I started doing scans the idea of chronic fatigue, oh you're a psychiatric patient, you're histrionic or there's secondary gain. There's a gain from being sick and then when you saw their scans, they were just devastated like the infectious scans you see. And all of the sudden it just completely changes everything on how you deal with this person. Of course they're hysterical. Their brain is not working right and they can't think. That'll make you terrible, act that way.
Dr. Emina: In some ways that actually connects into my last big lesson is that because now that I can look at scans you tend to see that the other things that contribute to whatever someone is coming in complaining about. All of the sudden if you see a brain that looks extremely unhealthy, you probably have to think that this person isn't just depressed. Maybe there's something else that's happening in their life and whatever situation, something they've been exposed to that's now leading them to present with whatever illness. Things that I wouldn't have even fathomed or thought contributed to mental illness or whatever before now I have to start thinking about. It's actually even expanded my thinking even greater than that because now I'm doing pharmacogenomics which is looking at how your body reacts to supplements, medicines and such based on your genetics. It's completely changed the way I think of brain health just because I get to see ...
Dr. Amen: So what are some of those things you've seen that have surprised you that can cause anxiety, depression, ADD?
Dr. Emina: One really important one is head trauma. Take a hit to the head, the one that you forgot about. There's no family history of any brain disorders or mental illness or whatever. All the sudden you're the one that has severe anxiety and anger outbursts. We take a look and everyone thinks it's something wrong with you. Also we take a look at your scan and you see significant damage to the temporal lobe. Now everybody in the family can say this is what's going on, this is the medical condition. If you had a broken leg, people wouldn't get angry at you for having a broken leg and not being able to walk as quickly as them. It now gives you an opportunity [inaudible 00:06:33] this is why you actually abuse substances because you were just trying to cope and this became a maladaptive or bad coping strategy. Now let's work on creating better coping strategies.
Dr. Amen: And often in the history they say they didn't have a head injury. You see it in the scan and then we have to ask over and over again and then we find they were in a bad car accident. They were thrown from a car ... whenever.
Dr. Emina: And one of the other biggest errors I'm actually learning about and this is actually in this last year I've been picking up more knowledge related to this are infectious type processes that can lead to presentations again whether it's you were exposed to mold or exposed to lime or even just kind of chronic based infectious or inflammatory responses that lead to the presentation and just continue to have these symptoms. I'm depressed, I'm anxious, I'm tired all the time and it's related to this potential infectious process or the thing that was going on for a long time. I've even started to see a connection with that and how to treat headaches too. You see certain things on the scan and there's a tendency that the genes or the genetics will match up a certain way. And that changes the way you go about treating that client too. It's amazing stuff.
Dr. Amen: Here at Amen Clinics we actually do a formal outcomes study on everybody we see. We have, 'cause people go what's your success rate using this scan? It's really high. If we treat you it's 84% of complicated people. On average, our patients and you know this, at 4.2 diagnoses, nobody's simple. They have failed 3.3 providers and 5 medications. That's our average. Daniel actually has one of the best success rates in the whole company so thank you. I'm very proud of you for that. But if you don't look, you don't know. Learn more about Amen Clinics and about our Northern California Clinic at AmenClinics.com. Have a great day.