Practicing traditional psychiatry for nearly a decade, I became saddened that many persons with persistent mental disorders didn't become well. The intensity of their symptoms had improved, but they still suffered and their lives were diminished. My colleagues and I had no way to convert their symptoms and behaviors into physiologic reasoning. I was frustrated and disillusioned by the lack of an objective clinical method by which to separate physiology from psychology.
My solution was to return to the medical model and procedures I had employed in general practice. I started examining patients again, but it was necessary to survey all of the bodily systems, not just the organs or systems about which they had concerns. Since the brain controls all the physical systems, I had to collect as complete a set of physiologic information as possible to fry to figure out individual differences in brain function. This detailed approach yielded measurable clinical findings which helped me identify the presence of anomalous neurophysiology; however, I still needed a medical tool to fathom any differences in neurophysiology.
In 1986, I began a medical research project using EEG and quantitative EEG (QEEG) technology. Studying visual EEG patterns and QEEG measures in patients whose psychiatric treatments had been ineffective, I learned how different medications affect particular EEG/QEEG measures. Applying the medical rule to "sort physiology first", I abandoned the psychiatric approach, aimed medical treatment to improve each patient's physiology and developed a database of EEG/QEEG features and their differential response and nonresponse to medications.
A medical doctor's job is to convert a patient's symptoms into physiologic reasoning and prescribe a regimen to improve the physiology; therefore, those with brain-based conditions needed physiologic reasoning to unify brain and body. It was necessary to evolve a new craft on Axis III in order to figure out the underlying brain and body interactions that were likely causing each person's symptoms and behaviors that I had labeled on Axis I.
The clinical approach that I evolved is based on homeostasis, the established organizing principle of complex physiology. This patient-centric model collects and monitors any variant physical findings caused by dys-autonomia and aims treatment to achieve brain-body balance. Clinical experience shows that persons with similar symptoms and behaviors respond to different medication and those with different symptoms and behaviors respond to similar agents. To identify a causal neurophysiology, a prospective patient's EEG data are extracted and compared with a large, clinical outcomes database of heterogeneous EEG's and their known medicinal responses. The EEG data are mathematically classified and correlated with naturopathic and allopathic agents likely to improve a particular brain variance.
In treating thousands of patients across the array of mental disorders and physical illnesses, my understanding of mental disorders has radically changed. I now know that healthy persons are merely genetically fortunate, because they inherited brain-body balance. This is why they enjoy predictable physical and mental wellbeing without much effort. Yet, those with persistent conditions involving physical, learning, mental or substance dependence disorders are not as fortunate. These are the patients who remain physically ill with conditions which are only described by symptoms and behaviors
My experience with applying individual EEG data in clinical practice has convinced me that persons with a brain-based mental disorder are only trying to achieve relief from an abnormal neurobiology. They find ways to help themselves through persistent substance abuse, bingeing, purging, restricting food, obsessions, compulsions, self-mutilation, suicide and/or violence, etc. Such behaviors change physiology and give transitory relief. Although the behaviors appear maladaptive, they are actually attempts at adaptation.
When a behavior partially relieves the pathophysiology associated with a mental disorder, the behavior is reinforced and becomes habitual. The goal of my medical treatment is to provide an effective, enduring medical regimen for each patient based on brain-body balance/homeostasis.
Some psychiatrists continue to be apologists for the current approach that sorts, labels and treats patients by phenomenology; moreover, some continue to wait for new technologies to inform about genetic variations and neuronal circuits, trusting that biomarkers among patients with similar phenomena will lead to more effective medical therapy. This expectation ignores the brain's primarily homeostatic functions which can be accessed by a doctor's examination and use of EEG and QEEG data.
Inherited variations in functional brain activity have yet to be included in everyday medical practice. The result is that too many people remain afflicted with genetically based conditions which cause disturbed behaviors. Humanity needs a new type of medical doctor who is trained in this medical approach and learns to apply homeostatic physiology and EEG measures on Axis III before prescribing treatment for an Axis I Disorder. Patients with neurodevelopmental conditions can benefit from knowledge-based treatment that is informed by comprehensive physiologic evidence. This is the way we can reduce the suffering and stigma that psychiatric patients endure.
Monoamine Oxidase Inhibition in a Patient With Type I Diabetes and Depression Emory H. and Mizrahi, N, //
(Journal of Diabetes Science and Technology. DOI: 10.1177/1932296816638106)
Dr. Hamlin Emory Speaks in Washington State - Finding and Fixing Unrecognized Brain Differences