Treating the brain for

ANXIETY AND
DEPRESSION
INTRODUCTION
More than 30 years ago, our doctors at Amen Clinics began using SPECT imaging
to understand the function of each patient’s brain. By doing this, one of the
earliest—and most significant—lessons we learned was that Anxiety and
Depression are not single or simple disorders. We discovered there are 7 Types
of Anxiety and Depression. Each type has a different blood flow pattern and a
unique set of symptoms that require a customized—rather than a cookie-cutter—
treatment strategy to create the best possible outcome for each of our patients.

THE 7 TYPES OF ANXIETY AND DEPRESSION ARE:

1. Pure Anxiety
2. Pure Depression
3. Mixed Anxiety and Depression
4. Overfocused
5. Temporal Lobe
6. Cyclic
7. Unfocused

In this eBook, you will learn more about the 7 Types of Anxiety and
Depression, including their unique characteristics, some quick facts,
and tips for managing symptoms.

ANXIET Y AND DEPRESSION AMENCLINICS .COM 1

TYPE 1 PURE ANXIETY
On brain SPECT scans, people with Pure Anxiety show increased activity at rest
and during concentration in an area called the basal ganglia. These brain structures
are involved with integrating feelings, thoughts, and movement and play a role in
motivation. At Amen Clinics, we have found that the basal ganglia also help to
set the body’s idle and anxiety level.

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SYMPTOMS OF PURE ANXIETY
• Frequent feelings of nervousness or anxiety
• Panic attacks
• Avoidance of people or places due to a fear of having anxiety
or panic attacks
• Physical symptoms, such as headaches, sore muscles, and trembling hands
• Periods of heart pounding, nausea, or dizziness
• Tendency to predict the worst
• Multiple persistent fears or phobias
(such as dying or doing something crazy)
• Conflict avoidance
• Excessive fear of being judged or scrutinized by others
• Being easily startled
• A tendency to freeze in anxiety-provoking or intense situations
• Shyness, timidity, and getting easily embarrassed
• Biting fingernails or picking skin

QUICK FACTS ABOUT PURE ANXIETY

1 Many people with this type feel like they have an overload of tension
and emotion that can be disruptive to their lives. Some feel like they
are going to “jump out of their skin.”

2 Some of the most successful individuals we have scanned and treated

at Amen Clinics have significant increased activity in their basal
ganglia. We theorize this helps to drive their strong motivation.

3 Prescription anti-anxiety medications, such as benzodiazepines, are

harmful to the brain. They lower blood flow in the brain, and research
shows that if they are taken for a long period of time, the risk of
dementia increases by more than 50%.

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3 TIPS FOR MANAGING THE
SYMTOMS OF PURE ANXIETY
1 Focusing on your breath for a few minutes is one of the simplest
— and quickest — ways to settle your nerves. Practice
the “3 + 6 X 10” breathing technique:

• Inhale for 3 seconds through your nose.

• Hold for 1 second.
• Exhale for 6 seconds (twice as long as the inhale).
• Hold for 1 second.
• Repeat 10 times. This will take less than 2 minutes.

2 Learning to identify and challenge the ANTs (automatic negative

thoughts) that constantly run through your mind can help you get
control over the thoughts that make you worried, stressed, and nervous.

3 Using mental imagery of warm things, such as holding a

cup of tea, a puppy, or running your hands under warm
water can induce a sense of relaxation.

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TYPE 2
PURE
DEPRESSION
Pure Depression results from high activity
in the brain’s deep limbic system, which is
our emotional center. On brain SPECT imaging,
the scans of patients with Pure Depression
typically show markedly increased activity
in the deep limbic area at rest and during
concentration as well as decreased activity
in the prefrontal cortex on the resting scan
that improves with concentration.

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 SYMPTOMS OF PURE DEPRESSION
• Persistent sad or “empty” mood
• Loss of interest or pleasure in activities that are usually
enjoyable, including sex
• Restlessness, irritability, or excessive crying
• Feelings of guilt, worthlessness, helplessness, hopelessness,
and/or pessimism
• Sleeping too much or too little, early-morning awakening
• Loss of appetite and/or weight loss, or overeating and weight gain
• Fatigue, decreased energy, and feeling “slowed down”
• Thoughts of death or suicide, or suicide attempts
• Difficulty concentrating, remembering, or making decisions
• Persistent physical symptoms that do not respond to treatment,
such as headaches, digestive disorders, and chronic pain
• Constant negativity or chronic low self-esteem
• Persistent feelings of dissatisfaction or boredom

3 QUICK FACTS ABOUT

PURE DEPRESSION

1 Depression has many different underlying causes, and the only way to really
know what is driving symptoms is to actually look at a person’s brain.

2 Symptoms of depression can range from chronic mild sadness, called dysthymia,
to major depressive disorder, which can lead to long-term disability.

3 People who have the brain pattern associated with Pure Depression tend
to be sensitive, deeply feeling, and empathic. It’s not unusual for them to
channel these traits into creative endeavors.

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 3 TIPS FOR MANAGING THE
SYMPTOMS OF PURE DEPRESSION
1 Engaging in some form of physical activity is one of the best ways to lift
your mood and boost your energy.

2 Essential oils, such as lavender and jasmine, have mood-enhancing effects.

Simply add a few drops to a room diffuser!

3 By writing down 3 things you’re grateful for each day, you can shift your
attention from negative thoughts to more positive feelings.

ANXIET YANXIET Y AND DEPRESSION

AND DEPRESSION AMENCLINICS
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7
TYPE 3
MIXED
ANXIETY
AND
DEPRESSION
Mixed Anxiety and Depression involves
a combination of both Pure Anxiety and
Pure Depression. Brain SPECT imaging
reveals that people with this type have
high activity in the basal ganglia
structures that integrate feelings,
thoughts, and movement, and are
involved in motivation—and the deep
limbic system, which is the brain’s
emotional center. People with this
type have a mix of both anxiety
and depression symptoms.

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 ANXIETY SYMPTOMS INCLUDE
• Frequent feelings of nervousness or anxiety
• Panic attacks
• Avoidance of people or places due to a fear of having anxiety or panic attacks
• Physical symptoms, such as headaches, sore muscles, and trembling hands
• Periods of heart pounding, nausea, or dizziness
• Tendency to predict the worst
• Multiple persistent fears or phobias (such as dying or doing something crazy)
• Conflict avoidance
• Excessive fear of being judged or scrutinized by others
• Being easily startled
• A tendency to freeze in anxiety-provoking
or intense situations
• Shyness, timidity, and getting
easily embarrassed
• Biting fingernails
or picking skin

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 DEPRESSION SYMPTOMS INCLUDE
• Persistent sad or “empty” mood
• Loss of interest or pleasure in activities that are usually enjoyable,
including sex
• Restlessness, irritability, or excessive crying
• Feelings of guilt, worthlessness, helplessness, hopelessness,
and/or pessimism
• Sleeping too much or too little, early-morning awakening
• Loss of appetite and/or weight loss, or overeating and weight gain
• Fatigue, decreased energy, and feeling “slowed down”
• Thoughts of death or suicide, or suicide attempts
• Difficulty concentrating, remembering, or making decisions
• Persistent physical symptoms that do not respond to treatment,
such as headaches, digestive disorders, and chronic pain
• Constant negativity or chronic low self-esteem
• Persistent feelings of dissatisfaction or boredom

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 3 QUICK FACTS ABOUT
MIXED ANXIETY AND DEPRESSION
1 Anxiety and depression occur together 75% of the time.

2 Symptoms of either anxiety or depression may predominate at different

times, but both symptom clusters are present on a regular basis.

3 It’s not unusual for people with Mixed Anxiety and Depression to
self-medicate with toxic substances that calm the brain, such as
alcohol or marijuana.

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 3 TIPS FOR MANAGING
THE SYMPTOMS OF
MIXED ANXIETY AND DEPRESSION
Whether you are feeling anxious or depressed, identify and challenge your
automatic negative thoughts (ANTs) that are making you feel worse. Ask
yourself if the thought is 100% true. There’s a good chance it is not.

Spending 10 to 20 minutes each day in meditation can improve your mood

by calming the stress and anxiety that often lead to depression.

Getting regular exercise is a great way to discharge anxious energy and

clear your mind. It can also provide a release of endorphin hormones
which help lift your mood.

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 TYPE 4
OVERFOCUSED
ANXIETY
AND DEPRESSION
On brain SPECT scans, people with Overfocused Anxiety and Depression
have high activity in the basal ganglia, deep limbic system, and the anterior
cingulate gyrus (ACG)—the brain’s gear shifter. The overactivity in the
ACG makes it more difficult for them to let go of anxious and/or
negative thoughts or behaviors.

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 SYMPTOMS OF OVERFOCUSED
ANXIETY AND DEPRESSION
People with this type generally have 4 symptoms from Pure Anxiety (on page 3)
and/or 4 symptoms from Pure Depression (on page 6), in addition to these:

• Excessive or senseless worrying

• Becoming upset when things are out of place, or something
doesn’t go as planned
• Tendency to be oppositional or argumentative
• Intense dislike for change
• Vulnerability to compulsive or addictive behaviors
• Tendency to have repetitive negative or anxious thoughts
• Holding onto grudges
• Difficulty seeing options in situations
• Clinging to one’s own opinion and not listening to others
• Needing to have things done a certain way or you become upset
• Others complain you worry too much
• Habitually saying “no” without first thinking about the question asked

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 3 QUICK FACTS
ABOUT
OVERFOCUSED
ANXIETY AND
DEPRESSION

1 Conditions that fit into

Type 4 include:

• Obsessive compulsive disorder

(OCD): stuck on negative
thoughts or actions

• Phobias: stuck on a fear

• Eating disorders: stuck on

negative eating behavior

• Posttraumatic stress disorder

(PTSD) stuck on a past
traumatic event

2 Overfocused Anxiety and

Depression is seen more
frequently in the children or
grandchildren of alcoholics.

3 People with this type tend to

notice what’s wrong more than
they notice what is right.

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 15

3 TIP FOR
MANAGING THE
SYMPTOMS OF
OVERFOCUSED
ANXIETY AND
DEPRESSION

1 Whenever you notice yourself

getting stuck on negative or
anxious thoughts, envision a
red stop sign and think “STOP!”

2 To prevent anxious or negative

thoughts from looping endlessly
in your mind, write them down in
a journal. This can help you get
them out of your head.

3 Eat foods that boost the

neurotransmitter serotonin,
which can help calm an
overactive ACG. To do this,
include sweet potatoes,
hummus, salmon, turkey, eggs,
nuts, and seeds in your diet.

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 TYPE 5
TEMPORAL LOBE
ANXIETY AND
DEPRESSION
Temporal Lobe Anxiety and Depression is related to having too little or too much
activity in the temporal lobes, which are located on the sides of the brain. These
structures are involved with mood stability, emotion, learning, and memory.
People with Type 5 also have high activity in their basal ganglia and/or deep limbic
system. People with Temporal Lobe Anxiety and Depression generally
have 4 symptoms from Pure Anxiety (on page 3) and/or 4 symptoms from Pure
Depression (on page 6) in addition to at least 4 temporal lobe symptoms.

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 TEMPORAL LOBE SYMPTOMS
• Short fuse or periods of extreme irritability
• Periods of rage with little provocation
• Often misinterpreting comments as negative when they
are not intended to be
• Periods of spaciness or confusion
• Periods of panic and/or fear for no specific reason
• Visual or auditory changes, such as seeing shadows
or hearing muffled sounds
• Frequent episodes of déjà vu
• Sensitivity or mild paranoia
• Headaches or abdominal pain of uncertain origin
• History of head injury
• Family history of violence or explosiveness
• Dark thoughts that may involve suicidal or homicidal ideation
• Periods of forgetfulness or memory problems

3 QUICK FACTS ABOUT

TEMPORAL LOBE
ANXIETY AND DEPRESSION
1 Because of their position in the brain, temporal lobes are vulnerable
to injury by a blow to the head from almost any angle.

2 Temporal lobe functions include understanding and processing language,

intermediate- and long-term memory storage, word retrieval, emotional
stability, and visual and auditory processing.

3 Low activity in the left temporal lobe is linked to reading problems

and irritability, while decreased activity on the right side can cause
difficulty understanding social situations.

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 3 TIPS FOR MANAGING
THE SYMPTOMSBOUT
OF OVERFOCUSED
ANXIETY AND DEPRESSION
1 Working with a psychotherapist on strategies for anger management can
help people with Type 5 keep their cool.

2 Hum and/or sing more because both can make a positive difference
on mood and memory.

3 Since the temporal lopes are involved with processing

and producing rhythms, activities like dancing,
chanting, and other forms of rhythmic
movement can be healing.

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TYPE 6
CLINICAL
ANXIETY
AND
DEPRESSION
Type 6 is characterized by cyclic patterns
of anxiety and depression that fluctuate
in intensity. This is a spectrum disorder
ranging from mild to severe, so SPECT
scan findings will vary depending on
the phase a person is in. For example,
when their mood is very elevated, scans
typically show high activity throughout
the brain, while during a depressed
phase, there will be lower activity.

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SYMPTOMS
OF CYCLIC
ANXIETY
AND
DEPRESSION
People with this type generally have 4
symptoms from Pure Anxiety (on page 4)
and/or 4 symptoms from Pure Depression
(on page 7), and at least 4 cyclic
symptoms:
• Abnormally elevated, depressed,
or anxious mood
• Decreased need for sleep and feeling
energetic on dramatically less
sleep than normal
• Grandiose notions, ideas, or plans
• Increased talking or pressured speech
• Racing thoughts
• Markedly increased energy
• Poor judgment leading to risk-taking
behavior (departure from usual
behavior)
• Inappropriate social behavior
• Irritability or aggression
• Delusional or psychotic thinking
ANXIET Y AND DEPRESSION AMENCLINICS .COM
3 CYCLIC
FACTS ABOUT
CYCLIC
Conditions that fall under the Type 6
umbrella include: • Bipolar Disorder
• Cyclothymia
• Seasonal affective disorder
• Premenstrual dysphoric disorder
• Panic disorder (because panic
attacks are episodic and
unpredictable)
Intense stress, hormonal transitions,
and medication changes can exacerbate
symptoms, so a person with Type 6 should
be closely monitored during those times.
It’s not unusual for someone with Cyclic
Anxiety and Depression to require
medication to help balance their brain.
21
 3 TIPS FOR MANAGAING
THE SYMPTOMS OF
ANXIETY AND DEPRESSION

1 Eating foods that are high in omega-3 fatty acids, such as salmon,
tuna, avocados, and walnuts can help promote healthier moods.

2 Psychotherapy can be very beneficial for learning to manage the symptoms

of Type 6 as well as the stressors that potentially trigger episodes.

3 Challenging the automatic negative thoughts (ANTs) that

infest your mind can help create a more positive mood
and reduce feelings of agitation.

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 TYPE 7
UNFOCUSED ANXIETY
AND DEPRESSION
People with Type 7 are anxious and/or have low moods, in addition to having
difficulty with concentration and paying attention—or in some cases—
having brain fog. SPECT findings of this type show decreased activity in the
prefrontal cortex at rest and during concentration, as well as high activity in
the basal ganglia and/or the deep limbic system.

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 SYMPTOMS OF UNFOCUSED
ANXIETY AND DEPRESSION
• Feeling “spacey” • Forgetfulness
• Overwhelmed by the tasks of daily living • Difficulty expressing feelings
• Feeling tired, sluggish, or slow moving • Lack of empathy for others
• Procrastination, failure to finish things • Mental dullness
• Trouble staying focused • Brain fog
• Chronic boredom • Cognitive impairment
• Distractibility

3 QUICK FACTS ABOUT

UNFOCUCED ANXIETY
AND DEPRESSION
1 The brain dysfunction in Unfocused Anxiety and Depression may be
related to infections (such as Lyme disease or COVID-19), environmental toxins
(such as black mold or industrial fumes), head injuries, substance abuse, or
lack of oxygen (hypoxia).

2 Symptoms of Type 7 often look similar to ADD (also referred to as ADHD),

but SPECT imaging can help differentiate the two conditions, thus
treatment can be more precisely targeted.

3 Without getting the right help, people with this type often lack
motivation and have difficulty achieving their goals.

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 3 TIPS FOR MANAGAING
THE SYMPTOMS OF
UNFOCUCED ANXIETY
AND DEPRESSION
1 Eating a higher-protein, lower carbohydrate diet can help
to increase your focus.

2 To help stay on task with goals, do the One Page Miracle. Write down
your goals on a single sheet of paper, read it every day, and ask
yourself, “Is my behavior getting me what I want out of life?”

3 A regular practice of meditation can strengthen

the prefrontal cortex and improve focus.

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CONCLUSION
As you’ve learned in this eBook, the 7 Types of Anxiety
and Depression are complex conditions. Because there
are many overlapping symptoms, it can be very difficult
to get an accurate diagnosis unless you look at the brain.
With so much variation in brain function, there isn’t a
one-size-fits-all treatment that will work for everyone.
Furthermore, what is helpful for one type may worsen
symptoms for another type.

Left untreated, any of the 7 Types of Anxiety and

Depression can cause significant disruption to the
personal, professional, social, and occupational aspects of
a person’s life. In fact, untreated anxiety and depression
are associated with higher incidences of:

• Substance abuse
• Sleep problems
• Concentration issues
• Relationship problems
• Work issues
• Heart disease
• Physical ailments (colds, flu, and more)
• Suicidal thoughts and behavior

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 AMEN CLINICS
IS HERE FOR YOU.
The good news is, with the right diagnosis and a personalized targeted
treatment plan, people suffering with any of the 7 Types of Anxiety and
Depression can overcome their symptoms and have healthier, happier,
and more fulfilling lives.

Founded in 1989, Amen Clinics has built the world’s largest database of
functional brain scans related to behavior—more than 180,000 scans and
growing. As a world leader in brain health diagnosis and treatment, our
comprehensive evaluations include:

• Brain SPECT Imaging

• Neuropsychological testing
• Lab testing (when necessary)
• An in-depth look at the biological, psychological, social, and
spiritual factors that may be contributing to your symptoms

We offer in-clinic brain scanning and appointments, as well as mental

telehealth, remote clinical evaluations, and video therapy for adults,
children, teens, and couples.

Take the next step to start healing Anxiety and Depression and enhancing
your brain health by scheduling an appointment. Contact us today by visiting
our website at AmenClinics.com or click the button below to speak with one
of our care coordinators to answer your questions and help you find the best
solutions for you and your loved ones.

CO N TACT U S TO DAY

ANXIET Y AND DEPRESSION AMENCLINICS .COM 27

Amen Clinics is a part of Daniel Amen, MD’s united organizations dedicated to revolutionize psychiatry by teaching, training, and treating brain health.