
When Talk Therapy Doesn’t Work—What to Do Next
Why doesn’t therapy work for everyone? Learn the signs it’s not helping and what to do when talk therapy fails to support your healing.
Experienced mental health professionals can tell if someone is likely to have clinical depression, anxiety disorders, or anger issues. By asking about a person’s symptoms, they may recognize symptom clusters associated with ADD/ADHD, obsessive-compulsive disorder (OCD), or bipolar disorder.
However, what most psychiatrists and psychologists cannot do—and will never be able to do—is to know the underlying brain biology of the patients they treat. That’s because most mental health professionals don’t use functional brain imaging as part of their evaluation process.
Why is this so important?
In this blog, you’ll discover how functional brain imaging can help you find out what’s causing your mental health symptoms, so you can get the most effective treatment plan for your needs.
Functional brain imaging can help you find out what’s causing your mental health symptoms and which treatments will be most effective for you.
Without using functional brain scans—such as SPECT (single photon emission computed tomography) or QEEG (quantitative electroencephalogram)—your doctor cannot tell if your inattention, depression, compulsions, mood swings, or aggression is from:
If mental health professionals don’t look at the brain, they are unnecessarily flying blind. That can lead them to miss important diagnoses, give the wrong treatment plan, and hurt the people they are entrusted to help.
Jason is a prime example of how not looking at the brain can be life-threatening. He was 18 and in his first year in college at the University of Rhode Island when he first started hearing voices and having visual hallucinations.
Based on his symptoms, the university psychiatrist diagnosed him with schizophrenia and told his parents he would need to be on antipsychotic medication for the rest of his life. But the medication triggered suicidal thoughts.
Horrified, his mother called Amen Clinics, where Jason underwent a functional brain-imaging study.
Jason’s SPECT scan showed evidence of a past brain injury affecting his left temporal lobe, which when damaged is often involved in mood instability, dark thoughts, and hallucinations. It also showed low activity in his frontal lobes (where focus, forethought, and planning occur).
When he was 5 years old, Jason jumped headfirst into an empty bathtub and was unconscious for a brief period. He also had sustained several concussions from wrestling and playing soccer.
Since the age of 5, Jason had struggled with low-grade depression. His symptoms worsened when he was 12 years old and experienced bullying at school.
While at college, Jason started hearing voices. They constantly made mean comments about him and others. Often, the voices would speak at the same time. In addition, he began seeing gory visions of his own death, including being strangled by a snake.
After a comprehensive evaluation at Amen Clinics, including his personal history, SPECT brain scans, neuropsychological assessments, and more, his diagnosis changed.
Jason didn’t have schizophrenia. Rather, he had experienced a psychotic depression, which had been made worse by the prior brain injury, undisciplined thought patterns, and chronic stress.
Jason stopped taking his antipsychotic medication and began supporting his brain recovery with healing nutrients and cognitive behavioral therapy (CBT). He also did multiple sessions of hyperbaric oxygen therapy (HBOT) to help heal his prior brain injury.
Within 4 months, Jason was remarkably improved and the following year he was back at school. If no one had ever looked at his brain and put him on a more effective treatment plan, his life would have been very different.
Functional brain imaging takes psychiatry from a generalized symptom-cluster diagnostic and treatment specialty without any biological evidence to a more objective specialty, one that is solidly based on using state-of-the-art brain mapping tools to help optimize the patient’s brain function.
Besides completely changing the way mental health professionals diagnose mental health disorders, functional imaging leads to completely different treatment protocols to improve brain function.
By finding the root causes of your symptoms—such as exposure to toxic mold, Lyme disease, or a past head injury—you can get more targeted treatment that works.
For example, if your depressive symptoms are related to toxic mold exposure, it’s unlikely that antidepressant medications are going to help. Unless you eliminate the mold, you’re going to continue struggling with low moods.
Similarly, if Lyme disease is causing psychotic episodes, but you’re diagnosed with schizophrenia, antipsychotics won’t work. You have to treat the underlying infection.
When brain scans help a psychiatrist get to the root causes, you’re more likely to feel better faster.
Looking at the brain also leads to more natural strategies to treat mental health conditions. Seeing areas of the brain that are either overactive or underactive helps physicians pinpoint lifestyle habits to optimize brain function.
If you’re struggling with mental health symptoms that aren’t responding to traditional treatments or psychiatric medications, it’s a good idea to consider a brain scan. Additional biological information can be so helpful in discovering why you feel depressed, anxious, angry, or unfocused. And it can give you a clearer roadmap to healing.
American Psychological Association Website
What Is Psychiatry?
https://www.psychiatry.org/patients-families/psychotherapy
Accessed April 18, 2025
How Long Will It Take for Treatment to Work?
https://www.apa.org/ptsd-guideline/patients-and-families/length-treatment
Accessed April 18, 2025
Jacob, J., Stankovic, M., Spuerck, I. et al. Goal setting with young people for anxiety and depression: What works for whom in therapeutic relationships? A literature review and insight analysis. BMC Psychol 10, 171 (2022).
Law C, et al. Exposure and Response Prevention in the Treatment of Obsessive-Compulsive Disorder: Current Perspectives. Psychol Res Behav Manag. 2019 Dec 24;12:1167–1174.
Wilson G, et al. The Use of Eye-Movement Desensitization Reprocessing (EMDR) Therapy in Treating Post-traumatic Stress Disorder—A Systematic Narrative Review. Front Psychol. 2018 Jun 6;9:923.
NIH: National Library of Medicine
National Center for Biotechnology Information
Psychotherapy and Therapeutic Relationship
https://www.ncbi.nlm.nih.gov/books/NBK608012/
Accessed April 18, 2025
Vermani M, et al. Rates of Detection of Mood and Anxiety Disorders in Primary Care: A Descriptive, Cross-Sectional Study. Prim Care Companion. 2011;13(2):PCC.10m01013.
Swift J, Callahan J. Decreasing treatment dropout by addressing expectations for treatment length. Psychother Res. 2011 Mar;21(2):193-200.
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