Neuropsychiatry involves treating the emotional, behavioral, and cognitive symptoms that occur in the context of psychiatric diseases (depression, anxiety, bipolar disorder, PTSD, substance use disorders, schizophrenia) and neurological diseases (Parkinson’s disease, multiple sclerosis, dementia) and brain injuries. Brain injuries can have multiple causes including trauma (traumatic brain injury), stroke, brain infection, hypoxia (loss of oxygen), cancer (effect of the tumor or of the tumor resection, toxin exposure (i.e. lead poisoning), and many others.
When the brain is injured, a variety of emotional, behavioral, and cognitive symptoms can occur. These symptoms include depression, anxiety, anger, aggression, impulsivity, and memory impairment. A person who was previously functioning normally may feel and behave much differently, causing significant distress and having an adverse effect on their lives. It is not uncommon for these problems to continue even years after the injury has occurred.
Ultimately, whether symptoms are the result of psychiatric or neurologic disorders, the root cause is brain dysfunction.The core of neuropsychiatric practice involves figuring out the cause of the person’s symptoms and figuring out why they are having problems functioning.
Treatment is multifaceted, holistic, and is based on diagnosis. For example, depression may be due genetics, vitamin deficiencies, psychologically traumatic experiences, injury to the frontal lobe, a hormonal disturbance caused by injury to the pituitary gland, or precipitated by loss of functionality in daily life. Depression will, for the most part, look the same regardless of cause. But treatment will certainly differ depending on the cause.
Another large area under the scope of our specialty is the diagnosis and management of dementia. Dementia essentially means a loss of cognition or memory. There are many different causes of dementia, including Alzheimer’s, Lewy Body disease, and frontotemporal pathology. They can happen in mid-life and late-life, and can be difficult to differentiate from one another. Each type of dementia has a different disease course and is treated differently, making diagnosis of utmost importance. Sophisticated brain imaging and genetic testing can help in the diagnostic process, and also assist in family planning for the children of those affected by these diseases.
We have recently started a cutting edge dementia treatment protocol which was founded by Dr. Dale Bredesen at UCLA. This program, MEND (Metabolic Enhancement for Neurodegeneration), involves reducing inflammation, reducing toxin exposure, improving nutritional status, and many other treatment modalities. Two scientific papers have been published in a peer-reviewed medical journal, showing reversal of cognitive impairment in those who had confirmed cases of Alzheimer’s disease. This treatment protocol is extensive, and requires much effort from the patient and their family.