Case Study - My Patient Cassie

Cassie
As forty-three-year-old Cassie sat on the blue leather couch in the Amen Clime, tears flowed down her cheeks as she said she could no longer focus on her work as the head of a nonprofit corporation. She could not escape feeling sad and nervous and being overwhelmed by negative, self-loathing thoughts. She said she was weeks behind on an important project and was on the verge of being fired from a job she had loved for more than ten years. The trigger to this episode of inner turmoil (she had had another period in college) was her failure to get pregnant. She had one child, an eight-year-old son, but was unable to get pregnant again, although she and her husband had been trying for six years. She always wanted to raise a daughter and was be­ginning to believe that it would never happen. She cried for hours every day and felt sad, hopeless, worthless, like less than a woman, and, at times, even suicidal. Additionally; she had frequent headaches, no interest in sex, and was very irritable with her son and husband. Her symptoms worsened dur­ing the last two weeks of her menstrual cycle. Her husband stayed at work longer to avoid her emotional storms. Her son felt the tension at home and had trouble focusing at school. She came to the Amen Clinic after she saw a story on television about our brain imaging work.


After taking her history and performing a noninvasive brain scan called SPECT (single photon emission computed tomography) we discovered that Cassie's emotional brain was dramatically overactive. She had too much ac­tivity in her limbic system, putting her at risk for depression; too much activity in her basal ganglia, causing her to feel anxious and emotionally stirred up; and too much activity in her anterior cingulate gyrus, causing her to get stuck on negative thoughts and behaviors. She had "brain reasons" for feeling so awful. To us, this pattern was very clear. She had Type 4, Over-focused Anxiety/Depression, one of seven new types of anxiety and depression that we have described based on our extensive brain imaging work. With the right combination of medication and therapy, Cassie began to heal. Be­cause family members often suffer along with the person who has the illness, we included her husband in the treatment process. The brain scans helped her husband understand that his wife was suffering from something specific, not just acting badly. He became an active participant in her healing process because he wanted his wife back. As Cassie began to heal, her marriage Strengthened, and she became a more consistent parent to her son. Cassie Said the brain scans helped her better understand her illness, forgive herself for her erratic behavior, and be consistent with the treatment she needed.



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