The 11 Risk Factors That Are Destroying Your Brain - Dr Daniel Amen

Brain Imaging and the Revolution in Psychiatry

Dr. Amen begins by highlighting the transformative power of brain imaging in psychiatry. Unlike traditional psychiatry, which often relies solely on symptom clusters and talk therapy without directly examining the brain, his use of SPECT scans allows for a hard science approach. These scans reveal how different areas of the brain function, showing whether activity is too high, too low, or balanced. This data-driven method enables personalized treatment plans aimed at improving brain function, which in turn improves mental health outcomes.

He explains that this approach upends psychiatry’s stagnant outcomes, which have not significantly improved since the 1950s. By focusing on the brain’s structure and function, clinicians can better understand the root causes of mental health symptoms rather than just managing behaviors or emotions. Dr. Amen stresses that the brain is the hardware, and the mind is the software; if the hardware is compromised, the software cannot run properly. This perspective shifts the focus from stigmatizing mental illness to empowering individuals to care for their brain health.

Distinguishing Mental Health from Brain Health

A central theme in Dr. Amen’s work is the distinction between mental health and brain health. He argues that calling someone “mental” carries stigma and shame, whereas framing issues as brain health problems elevates the conversation and opens the door to compassion and science-based interventions. Mental health symptoms—such as anxiety, depression, or behavioral issues—are manifestations of underlying brain dysfunction.

He elaborates that brain health encompasses both structural and functional aspects. Structural imaging like MRI or CT scans shows the anatomy of the brain, but functional imaging like SPECT reveals how well the brain is working in real time. Many psychiatric problems are functional rather than structural, meaning the brain’s hardware is intact but not operating optimally. This understanding allows for targeted treatments that address specific brain circuits rather than broad symptom categories.

The Impact of Substance Use on Brain Function

Dr. Amen discusses the profound negative effects of substances like alcohol, marijuana, and even some recreational drugs on brain health. He notes a worrying trend where younger generations, particularly Gen Z, are using marijuana more than alcohol, despite marijuana’s detrimental impact on brain blood flow and activity. His research shows that marijuana use lowers brain activity in critical areas related to learning and memory, effectively aging the brain prematurely.

Alcohol, too, is a major toxin to the brain, making it look older and impairing function. Dr. Amen shares how visual brain scans have been used as motivational tools to help patients see the damage caused by substance abuse and inspire change. He also highlights the irony that substances people use to self-medicate anxiety or other symptoms often worsen those very symptoms over time, creating a vicious cycle.

Nutrition and Its Role in Brain Health

Nutrition plays a pivotal role in brain function, according to Dr. Amen. He points out that many processed foods contain artificial dyes, sweeteners, gluten, and dairy, which can exacerbate or even mimic symptoms of ADHD and other brain disorders. For example, gluten breaks down into glutomorphins, and dairy into caseomorphins, both of which act on the brain’s opiate centers, dulling cognitive clarity and increasing dysfunction.

He advocates for dietary interventions as a first step before medication, especially in children suspected of having ADHD. Studies have shown that elimination diets removing gluten, dairy, and artificial additives can dramatically reduce ADHD symptoms in many children. Dr. Amen emphasizes that while not everyone is equally sensitive, many people benefit from cleaner, less processed diets that support brain health.

The “BRIGHT MINDS” Acronym: The 11 Major Risk Factors

Dr. Amen introduces his Alzheimer’s prevention program acronym, BRIGHT MINDS, which outlines the eleven major risk factors that steal brain health. These include blood flow, retirement and aging, inflammation, genetics, head trauma, toxins, mental health, immunity and infections, neurohormone abnormalities, diabesity (diabetes and obesity), and sleep. Each factor contributes to brain decline and cognitive dysfunction in unique ways.

For example, low blood flow is the top imaging predictor of Alzheimer’s disease and is worsened by caffeine, nicotine, alcohol, poor sleep, and obesity. Inflammation can arise from leaky gut or periodontal disease, making dental hygiene surprisingly important. Genetics are not destiny but a wake-up call to adopt preventive measures. Head trauma, even mild or subconcussive, is a major but often overlooked contributor to psychiatric and cognitive problems.

The Role of Infections and Immunity in Brain Disorders

One of the more surprising insights Dr. Amen shares is the role of infections in causing or exacerbating psychiatric disorders. He recounts cases where infections like Lyme disease, COVID-19, herpes, cytomegalovirus, and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) have led to severe brain inflammation and psychiatric symptoms such as hallucinations, aggression, and OCD.

These infections trigger immune responses that inflame the brain, disrupting normal function. Treating the underlying infection can dramatically improve or even resolve symptoms. This challenges the traditional view that psychiatric disorders are purely psychological or genetic and underscores the importance of comprehensive medical evaluation in mental health care.

Neurohormone Imbalances and Their Effects

Hormonal imbalances significantly affect brain function, according to Dr. Amen. He explains that estrogen, progesterone, thyroid hormones, and testosterone all influence mood, cognition, and behavior. For instance, low testosterone in men can reduce empathy and increase risk-taking, while fluctuations in female hormones can impact brain health and mood stability.

He also highlights how lifestyle factors like sugar intake can acutely lower testosterone levels, affecting energy and libido. Monitoring and optimizing hormone levels is a crucial part of maintaining brain health and preventing mood disorders. Hormone balance supports not only mental well-being but also physical health and longevity.

The Detrimental Effects of Diabesity on the Brain

Diabesity—a combination of diabetes and obesity—is a major threat to brain health. Dr. Amen points out that high blood sugar and excess weight contribute to nearly all other risk factors, including low blood flow, inflammation, genetic expression changes, and hormone imbalances. Fat tissue stores toxins and promotes chronic inflammation, which damages brain cells and impairs cognition.

He stresses that managing weight and blood sugar is essential for preserving brain function. This involves dietary control, regular exercise, and lifestyle changes. The modern diet, rich in ultraprocessed foods and sugars, is a key driver of diabesity and the associated cognitive decline seen in today’s population.

The Importance of Sleep for Brain Health

Sleep is a foundational pillar of brain health. Dr. Amen explains that sleeping at least seven and a half hours activates hundreds of health-promoting genes, while sleeping less than six hours shuts them down. Sleep supports memory consolidation, emotional regulation, and detoxification processes in the brain.

He likens going to bed to “washing your brain,” emphasizing that good sleep hygiene is critical for mental clarity and resilience. Poor sleep exacerbates many brain disorders and increases the risk of dementia. Simple habits like avoiding stimulating content before bed and maintaining a consistent sleep schedule can have profound benefits.

Managing Anxiety: Practical Strategies

Anxiety is a prevalent issue in modern society, and Dr. Amen offers practical advice for managing it. He recommends diaphragmatic breathing—breathing deeply into the belly with a slow exhale—as an effective, side-effect-free way to break panic attacks. This technique doubles lung capacity and calms the nervous system.

He also advises against avoidance behaviors, encouraging patients to stay in anxiety-provoking situations to prevent the anxiety from gaining control. Cognitive strategies like writing down anxious thoughts and questioning their validity help reduce their power. Supplements such as theanine, magnesium, and ashwagandha can support anxiety management, while benzodiazepines should be used cautiously due to addiction risks.

Supplements That Support Brain Function

Dr. Amen highlights several supplements with strong evidence for improving mood, cognition, and brain health. Omega-3 fatty acids are essential for memory and mood regulation, while saffron, the world’s most expensive spice, has been shown in numerous trials to be as effective as antidepressants with fewer side effects. Saffron appears to modulate neurotransmitters and reduce inflammation.

Other beneficial supplements include zinc, which enhances antidepressant effectiveness; curcumins from turmeric, which also boost mood and reduce inflammation; and SAMe, which supports pain relief and mood. Theanine, found in green tea, helps with anxiety and focus. He stresses the importance of methylated B vitamins, especially for those with genetic polymorphisms affecting folate metabolism.

Brain Health in Relationships and Communication

Finally, Dr. Amen explores how brain health influences relationships and communication. Healthy brains foster reliability, predictability, and emotional regulation, which are essential for loving partnerships. Dysfunctional brains, especially with low frontal lobe activity or hyperactive emotional centers, can lead to impulsivity, rumination, jealousy, and conflict.

He shares stories of couples whose brain scans guided targeted treatments that transformed their relationships. He also discusses how trauma, infections, and substance use can impair relational functioning. Teaching people to manage their “ants” (automatic negative thoughts) and communicate effectively can rewire the brain for healthier connections.