The U.S. Centers for Disease Control and Prevention suggests that there are 25.9 magnetic resonance imaging (MRI) machines per million people living in the United States in 2007. That’s a remarkable number of very expensive machines, and not surprisingly, experts often look for new and innovative ways to use the machines they’ve purchased. Each time they use the hulking piece of equipment, they have an opportunity to recoup their investment and make the purchase seem a little bit more worthwhile.
Often, experts use MRIs to diagnose real and serious physical ailments that could cause people pain and distress. But sometimes, the machines are used to help assist with symptoms that are more mental than physical. It’s a relatively new way to use an MRI, but experts suggest that these machines may have a role to play in the diagnosis and management of very serious mental illness.
An MRI uses electric currents and radio waves to develop a three-dimensional view of a body part. The technology is complicated and a little difficult to understand, but in essence, a person going through an MRI is shot through with a series of radio waves that capture details about the tissues inside the body. Those waves come together to form an image, which may or may not also include information about how much energy each tissue in the body produces.
Getting this kind of information is relatively easy, as an MRI is typically complete in about an hour. It’s not always a fun-filled hour for the person in the machine, however, as the magnets tend to be loud. They click on and off, and they seem to move back and forth just inches away from a person’s nose. Meanwhile, most MRI machines require people to lie down inside of very small tubes and hold perfectly still. Sometimes, people find the whole experience hard to bear.
Even so, spending an hour inside of an MRI machine can be worth it because the patient would like information about:
- Broken bones
- Cancerous tumors
- Torn tendons
- Digestive issues
- Chronic headaches
Sometimes, people will also go into an MRI machine because they have unusual changes in behavior, and they’re not sure why these changes are taking place.
Most changes in the way people think or act are attributed to mental illnesses that spring from tissues that are deep inside the brain. However, some changes in behavior can be attributed to structural problems that impact the tissues that surround the brain. For example, the American Brain Tumor Association suggests that cognitive and behavioral changes are often associated with brain tumors, and sometimes, those tissue changes can even cause a deterioration of motor skills, and a deep sensation of fatigue.
A person with a mental illness like depression might also seem sedated and slow, and someone who medicates depression with alcohol or drugs might also find it hard to keep errant muscles under control. If this person went to a doctor for help, and that doctor used only an interview to determine the source of the distress, the person might not get the help that could lead to a reduction in symptoms and distress. Meanwhile, the tumor could continue to grow.
For this reason, some experts would like their clients with symptoms of mental illnesses to get MRI tests, just so the experts can ensure that the changes the person is experiencing aren’t due to some kind of structural change in the tissues of the head. The brain scans are just a form of testing that could help experts to ensure that something physically serious isn’t taking hold inside the brain of the person.
There are some experts, however, who want to use MRIs in a completely different way. These experts aren’t necessarily interested in ruling out some kind of physical ailment. Instead, they’re hoping to use the tool to help them find the cause of a purely mental illness.
Understanding the Concept
If an MRI can show structural deformities in the brain, it’s reasonable to suggest that it might have a role to play in diagnosing a mental illness. Similarly, if an MRI can show energy use inside of the brain, it might very well demonstrate abnormalities in the way the brain processes information. If a person has an abnormal interview and a strange case history, and the MRI shows that portions of the brain are similar to other people who have a specific mental illness, it might be all too easy for a medical practitioner to provide an accurate diagnosis.But this kind of diagnosis would require an extensive library of MRI results. Basically, experts would need to compare the MRI results in front of them with images of both healthy people and those who have a variety of different mental illnesses. If the reviewer found an image that matched, and the symptoms reported by the people scanned also matched, the MRI could help to provide a diagnosis.Some experts are trying to pull together libraries like this, and when they do, the results can be impressive. For example, researchers working for the National Institutes of Mental Health in 2009 hoped to recruit people who had schizophrenia, along with people who didn’t, so multiple scans could be taken over a long period of time. With this library of images, diagnosing changes due to schizophrenia might be remarkably easy. However, this is the sort of study that might take decades to complete, and some people might drop out of the study before the scans are complete. It’s not at all certain that the work done as part of this experiment will end up benefitting people with mental illness.Small studies do suggest that MRI screenings can be helpful for people with relatively straightforward mental illnesses. For example, researchers writing for the journal Psychological Medicine performed scans on people who were healthy as well as people who had bipolar disorder. They then asked doctors to separate the ill from the well, based only on the results of the scans. More than 70 percent of accurate diagnoses were made in this way. This seems to suggest that scans can be vital in mental illness diagnosis, but there is reason to be cautious.
Participants in studies like this often have uncomplicated forms of mental illness because they:
- Are at risk for only one mental illness
- Don’t take drugs
- Do not have age-related brain changes due to dementia
- Have no past history of head trauma
People with these risk factors are often excluded from studies, because their test results might be so individualized that they skew the results of the entire study. However, people like this might very well have behavioral difficulties that merit a closer look, and all of their conditions might need to be treated. It’s hard to know if a scan is a good idea for people like this. The studies suggest that scans help in diagnosis, but the libraries of scans might exclude people with complicated medical problems like this. It’s hard to know just how useful a scan might be.
Downsides and Upsides
Families that are considering an MRI scan for mental health might need to really think about what the scan is designed to accomplish, and whether or not it’s worth their time and effort. Looking at the cost can sometimes make the decision a little easier for some families.
An MRI often costs more than $1,000 per patient in the United States, according to an analysis published in Kaiser Health News, and people who don’t have insurance might be asked to pay much more, as hospitals might increase the cost of testing for the uninsured in order to ensure that their facilities are profitable. That’s a huge expense for a family to absorb, and they might balk at paying for a test that’s so expensive when the results may or may not be meaningful.
However, getting a scan could be a good idea for families that just might be dealing with some kind of physical problem.
As mentioned, some mental illnesses have their roots in serious physical problems like cancer, and some symptoms could be caused by head injuries that seemed relatively minor at the time. Families that get scans could be provided with answers that inform their treatment plans, and the data they get could allow them to help their families in ways that just wouldn’t be possible if no scans were given. For some, it’s simply the right thing to do.
Preparing for Scans
In general, there’s very little that people must do in order to get their bodies ready for an MRI scan. As mentioned, the test is over in about an hour, and there’s no dietary restrictions or exercise restrictions involved in this particular test. But knowing a little more about what to expect on the day of the scan could help people to feel a little less stress as the test moves forward.
Since an MRI uses magnets, no metal pieces are allowed into the machines, including jewelry, snaps or buttons, hairpins and removable dental equipment. MRI operators often go over everything on a step-by-step basis to ensure that all offending items are removed before the test begins, but clients can help by ensuring that they leave everything metal at home. Wearing jogging pants with no zippers or snaps, leaving all jewels at home, and remembering to leave hair down could be quite helpful.
The machine can also be noisy, and some people find it helpful to practice their meditation skills in the days before the exam. Lying down, controlling breathing, and thinking of a safe and comfortable space are good ways to prepare for the time spent inside an MRI machine. Some people even download sounds of an MRI machine and play those sounds over headphones in the days that come before an MRI, so they won’t be surprised by the sounds when the test comes.
People with severe claustrophobia can be provided with medications to soothe them while the test is ongoing, but those drugs aren’t great options for people who have addictions. In fact, facilities might be leery of providing medications to people who arrive in the facility while intoxicated by other drugs. If clients can work on getting through the test without taking drugs, it is usually a better option.
If you’d like to know more about the place that an MRI might hold in your addiction treatment plan, or you need help in convincing someone you love to even talk about an addiction at all, we’d like to help. The Foundations Recovery Network facilities we highlight here have decades of experience in helping people who have mental illnesses and addictions, and we’re quite comfortable answering any question that concerns this particular field of medicine. We can even help you to find the right treatment program for you or for someone you love. Just call us to find out more.
David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.
Reviewed by: Kim Chin and Marian Newton