News Why don't psychiatrists look at the brain?

[Deadman]

So why don't psychiatrists actually look at the brain. Other doctors look at x-rays, sonograms, CAT scans, etc. Why not shrinks?

https://youtu.be/esPRsT-lmw8

 

[Friday]

We don't know enough about the brain, yet.

Also? Our toys suck. Seriously. Brain scans are about as detailed as photographs made by putting a leaf on silver paper, or xraying a computer & trying to figure out how it works based off of giants squares & tiny squares with random heat signatures. (Actually, neurology & comp sci work really closely together, academically. The more we understand about either helps the other field, exponentially). Or trying to understand human anatomy & physiology by using infrared from a helo. Shrug. Baby science. Still banging rocks together. Hell. Until just a few years ago we thought memory was discrete -contained in a single area- instead of diffuse (actually memory is stored in every single area of the brain). And that's old news in neurosci (enough to be textbook) but most of the population? Snort. Still thinks memory is based out of the hippocampus.

Until we have better toys? Yay, more sticking wires into mousey brains. :wtf:

 

[Deadman]

Bah! It's good enough to start looking. If we wait till it's good enough we'll never get there. Scan my brain dammit! Hell, stick wires in it if that will help.

Photography didn't really progress until people wanted to take them. Maybe it's time psychiatrists started demanding brain imaging and thereby spur improvements.

 

[joeylittle]

You mean, stuff like this?
Real-time Functional MRI and Neurofeedback of Brain Networks Mediating Trauma Memory Recall in PTSD - Full Text View - ClinicalTrials.gov :)

Get to know clinicaltrials.gov - it's quite worthwhile, even if only to have an overview on where the investigations are heading at any given moment.

 

[anthony]

They are looking, but your question is more psychiatrists specifically. The reason its useless for them, is that it would not lead them to any further objectivity towards diagnosis because the information neurology does have on synapse activity and such, can't be accurately interpreted into diagnostic application at the local level.

So to answer - psychiatrists would simply be involving a very tedious, time consuming, expensive, task into the diagnostic system that would not garnish results relevant to make a clear determination for a patient.

 

[Deadman]

OK let me restate things a little. The psychiatrist in the vid uses brain imaging. He gets results.

I've been asked numerous times if I have had a TBI. I don't know. I've had concussions. I've been caught in bomb blasts that left me with tinnitus. But I just have no way of knowing if I have a TBI. Nowhere in the diagnostic process did anyone suggest that it might be a good idea to actually look at my brain.

I understand that current science does not reliably show differences between PTSD affected brains and normal brains. But if nobody looks we'll never know if it's worthwhile or not.

It strikes me that it is similar to the medical marijuana issue. "Marijuana has no medical value, therefore, it is a scheduled drug and you can't study it to see if it has no medical value".

 

[EveHarrington]

My head is already pretty f*cked up, starting with imaging done of my head as a child that now isn't really considered safe. I'm not willing to put my brain on the chopping block-----I'd only consent to scans if the benefit outweighed the risk. And then of course there is the cost issue-----the cost of my last set of scans was RIDICULOUS!

Someone else, please be the Guinea pig!

 

[Friday]

:sneaky: I'm pretty notorious for volunteering to jump into the FMRI, PET, & other machines when given even half an opportunity.

It's wicked fun stuff.

We're just at the beginning, is all.

 

[Sideways]

I had my brain scanned...ahem, actually I think they've done that twice now.:confused:

It was to rule out any biological issues that might have been contributing to my mental health. I didn't realise I was in the minority having had that checked...:barefoot:

 

[Deleted member 541]

I think I've had at " least" 6 MRI's of my brain. They keep trying, but fail to find it!!!!! LOL!!! I do understand the question that @Deadman has asked. I guess I would ask... What would they use to confirm PTSD?

 

[joeylittle]

It was to rule out any biological issues that might have been contributing to my mental health

I would kill for this. It's why I'm now digging into studies and trying to qualify for one. I'd like to be a guinea pig.

@Deadman - I do think in the US, it's because without solid scientific research backing it up, insurance will not pay for the kinds of detailed scans one would need for it to even be hypothetically useful. So basically, money. It's expensive and docs have to justify what they order, plus patients have to demonstrate medical need.

In the socialized medicine countries, I don't know why it's not at least a little more common.

 

[anthony]

OK let me restate things a little. The psychiatrist in the vid uses brain imaging. He gets results.

I don't think you're going to get any argument about the state of mental health. What he is talking about, what you are talking about, is what many have talked about for a long time. Mental health is a best guess practice, which is being accepted as though valid. I believe our latest three piece article was on just this issue.

The problem -- this guy is a radiologist and psychiatrist. He and his colleagues, over 23 years, have performed 83000 scans. In the scheme of the world, that is really tiny.

Like what has already been said. What is known about the brain is super small in comparison to what is known about the body. Mental health must come to the psychical health side. It must... but how, is the question that must be answered.

SPECT is not a see all solution. He used words carefully in that video, and if you listen, he was not definitive. He in fact used a comparison showing two very different images of two people presenting with depression. Depression is the problem - so how does two vastly different brain activities correlate?

And back we are to -- there is just so little known about the brain, its activation, synapse firing, etc. What you're asking -- it is happening. It's happening because people are tired of this best guess scenario mental health have going on, with big Pharma super happy about best guessing as it keeps their products flowing.

The entire mental health industry is built on a foundation of bullshit. Crusty on top, hot underneath, stinks when you touch it, has flys all around it. Convert that to: hard to crack medically, its depths sink deeper than we can see right now, results are inconsistent and there are industries funding to keep things the way they are, because best guess is building their bottom line.

If you want to be a sociopath in the public eye, being a psychiatrist is the perfect job. You can literally abuse people to your hearts content, push them to kill themselves, justify anything you want, and its all ok -- because nobody has the answers yet.

A SPECT machine is half a million. Then you need a radiologist and a trained person to interpret the scans (neurology).

Now you're thinking the psychiatrist is trained? Wrong. Think GP. Medical doctor. They send you for scans (usually a place with all the expensive gear and radiologists in one place). They normally also refer you to a specialist who can read those scans correctly, specialist in that area of the body, so mistakes aren't made. Three people, regardless how you view this issue. A shrink is a GP + Ph.D psychologist.

Should psychiatry be this way? Absolutely. Again, not going get an argument about mental health being backed by something scientific and physical from me. The problem isn't that this won't happen, because the industry is being forced to change. The problem is that mental health has been so stigmatised for so long, that it always kept taking the back seat on anything productive, moving forward. Its only that walls are being broken down today about the stigmatisation and such of mental health, that we're starting to see active and positive change in treatment protocols. Just stepping back from pharmaceuticals has been a big change in the industry, and is happening world wide.

Mental health is a good century or more behind modern medicine. It won't take that long to catch-up, but it will take decades at best. We also still need to learn a whole lot more about the brain.

Here is the problem -- you can have two identical brain scans which you suspect are abnormal from most others, yet one has symptoms of x, and the other person is perfectly healthy, functional and normal in daily life, no symptoms. The results though for the brain.

This is what is unknown. If you start treating people based on a brain scan, saying this lit up area means this, then you've just gone back to the best guess situation, except now you're trying to quantify it that a brain scan says so. Even though the person is not enduring any such symptoms. This is the crux of the issue for mental health and brain scans. Yes, scans would get it started to providing some accuracy, but its not a total solution either. There is a lot of information on this subject that is fore and against results.

A broken bone is a broken bone, regardless the person. A damaged synapse does not seem to conform to the same principles of a bone or such, between brains.