Discussion Anyone ever had a brain scan during their diagnosis?

[Forever Sleep]

I've just come across this Ted Talk:



It's something I've always been curious about... Are brain scans done as part of the diagnosis process in mental illness? And if not- why not? (Cost I guess and maybe limiting the brain's exposure to radiation.) But seriously? What other medical professional diagnoses and medicates an illness solely by listening to a patient describe their symptoms?!! Imagine if they did that for cancer or appendecitis or heart disease? It just seems ridiculous!

Has anyone here been diagnosed for a mental illness via a brain scan or, is it always just looking for a cluster of symptoms? Why do you suppose psychiatry is so far behind other medicine in this regard and if this Dr is correct- which I'm sure he is- why are they putting up resistance to it? They prefer to just wing it?!! Seems weird to me.

 

[Myforevercharlie]

I had one, but if I remember correctly it was to see if I ever had a epileptic attack that ruined something in my brain . It's years ago so I'm not really sure. But my then doctor wanted to rule out everything physical first.

 

[TransilvanianHunger]

Are brain scans done as part of the diagnosis process in mental illness? And if not- why not? (Cost I guess and maybe limiting the brain's exposure to radiation.)

A brain scan is only useful if you know what to look for, but, despite decades of research, there are no clearly established neural correlates for most mental illnesses. Some physical illnesses can cause symptoms of mental illness, and if the clinician has any reason to suspect this might be the case (usually because the patient presents other symptoms that can be properly identified as having a physical cause) then a brain scan might be required. But it's not standard procedure, and it's up to the discretion of the treating clinician.

But seriously? What other medical professional diagnoses and medicates an illness solely by listening to a patient describe their symptoms?!! Imagine if they did that for cancer or appendecitis or heart disease? It just seems ridiculous!

Diagnoses in mental health have been horribly misused and abused for a long time, and are often completely misunderstood. At its core, a mental health diagnosis is only a term to describe a cluster of symptoms that the patient is experiencing. It doesn't tell you anything about causation, unlike diagnoses of physical illnesses. A physician can say "cancer" and point to a tumour, and proceed with treatment. A mental health practitioner has no such luxury. They can't say "depression" or "borderline personality disorder" and point to a specific part of the body to treat it.

Unfortunately, many clinicians have taken the lazy approach of using diagnoses for mental illness as if they had the same explanatory power diagnoses for physical ailments have. They say "depression" and hand you a bottle of pills.

Why do you suppose psychiatry is so far behind other medicine in this regard and if this Dr is correct- which I'm sure he is- why are they putting up resistance to it? They prefer to just wing it?!! Seems weird to me.

Treating an ill mind is not like treating an ill body, and mental health practitioners don't have the vast amounts of research that physicians have to back them up. There are some in psychiatry who are set in their ways, but I think that the majority of the field would welcome any guiding light if it meant that they're able to offer more effective treatments to their patients. The biomedical model of mental illness has failed to produce anything close to that, unfortunately.

EDIT: I shouldn't be surprised, but apparently this bloke's whole thing is selling SPECT scans at his clinics, for around $4,000 a pop, together with books and supplements to "treat" every condition known to man. There is no peer-reviewed evidence that SPECT scans (or any other neural imaging for that matter) are of any use in neuropsychiatric diagnosis, because there are no biomarkers in the brain that are clinically useful.

Oh, and apparently he can also diagnose people with their own flavours of mental disorders, like "Ring of Fire ADD", "Overfocused ADD", and "Limbic ADD". The amount of quackery on display is staggering.

 

[EvisceratedJester]

Usually they aren't. The psychiatrist that I saw at the inpatient program just had talks with me and if something we talked about caught her interest then she would and print out an assessment sheet and would read the questions off of it to me. The psychiatrist I saw after the program just gave me the assessment questionnaires to do in the waiting room and that was it.

I'd imagine the reason why they don't make brain scans apart of the diagnosing process is because of the fact that they cost too much, take too much time, there are mental illnesses that don't have any clearly established neural correlates to look for (as @TransilvanianHunger mentioned), and because, even it there were clear neural correlates for every mental illness, making them apart of the diagnostic process means taking away some of their power.

A lot of psychiatrist and psychotherapists get off on the power the position they are in gives them over their patients and, unlike other fields, it's very easy to get away with misdiagnosing others, thus making it easier to profit off of them. Even if clear neural correlates to each mental illness were established and could easily be diagnosed via a brain scan they would probably be against it.

The psychiartist I saw after the inpatient program was the actually the last psychiatrist I would ever see again (not counting the one I saw back in Novemeber while I was at the hospital to get a sh cut looked at). She got upset when my mom called her and told her she wasn't too keen on letting me take the meds she wanted to prescribe to me and proceeded to threaten to put me in mental hospital if she didn't put me on the meds.

Later on, I would end up coming to the conclusion that the diagnoses that they both gave me weren't even correct.

 

[TooConscious]

In the uk I've never known a neurologist suggest that although my depression didn't get mentioned until one of us brought it up in an unrelated context and scans I've had a few, due to a combination of falls, episodes of psychosis, physical confrontation facial wounds, and seizures. Hence speaking to a few consultant doctors around the experiences but I've never felt clear minded enough to have a conversation that I'd perhaps be interested in asking them some questions of things you don't hear about but we all seem to recognise and experience. But hey which of us can be perfect im not sure if it's even genuine suffering or just fatigue of existing anymore.

 

[leavingthesoultrap]

I had an EEG years ago. My brain was slightly overactive.