At our Brain Stimulation Clinic in Del Mar, San Diego, we believe precise diagnosis is key to effective mental health treatment. Our Comprehensive Quantitative Diagnosis approach combines cutting-edge neuroscience, advanced EEG brain mapping, and individualized testing to pinpoint the root causes of conditions like depression, anxiety, OCD, and more.
We measure this with two validated questionnaires that tell us (with about 95% certainty) the inborn tendencies for
Depression, Anxiety, Mood swings and Irritability as well as High or Low levels of Dopamine, Serotonin and Norepinephrine activity.
I) We check the genes for your neurotransmitter receptor types:
Your genes influence how your brain responds to important neurotransmitters like serotonin and dopamine. Specific genes such as SLC6A4 (Serotonin Transporter), 5HT2C (Serotonin Receptor), DRD2 (Dopamine Receptor), CACNA1(Calcium Channel), ANK3 (Sodium Channel), COMT (Catechol-O-Methyltransferase), and MTHFR(Methylenetetrahydrofolate Reductase) play a vital role in determining your mental health and how you respond to treatments. By examining these genes, our clinical team can personalize medication and therapy, optimizing their effectiveness and minimizing side effects, to provide you with the best possible outcome.
Your body processes medications using specialized liver enzymes, including CYP2D6, CYP2C19, and CYP3A4. These enzymes determine how quickly medications are broken down and cleared from your system, affecting how effective they are for you and whether you might experience side effects. By assessing these enzymes as part of our Comprehensive Quantitative Diagnosis, we gain critical insights to personalize medication types and doses precisely for your body’s unique needs, improving treatment outcomes and minimizing side effects.
Through validated psychological assessments, we measure core personality styles. Understanding your personality helps us predict how you might respond to stress, treatment, and recovery strategies.
Personality Style is a set of patterns of thinking, feeling, or behaving in different situations. Personality Style is made up of Temperament and Character. Temperament is what is pre-programmed either genetically or by early effects on the brain or both. Character is the set of learned abilities which a person may or may not have developed. Problems of temperament tend to need treatment with medication or brain stimulation but problems of character require some combination of psychotherapy, self directed informed change and or brain stimulation.
We first measure characterit predicts whether a personality style is a problem (personality disorder). The dimensions we use are those of the renown Robert Cloninger, MD who breaks down as follows:
We objectively evaluate the specific symptoms you’re experiencing, including their intensity, frequency, and impact on your daily life. Accurate symptom measurement ensures precise and targeted treatment.
We obtain a comprehensive set of symptoms including those which are criteria for Major Depressive Disorder, Bipolar Disorder, Schizophrenia, Insomnia and Sleep Disorders, Eating Disorders, Post Traumatic Stress Disorder, Generalized Anxiety Disorder, Panic Disorder, Social Anxiety Disorder, Obsessive Compulsive Disorder, Somatoform disorders, Addiction and Alcoholism. We are informed by the DSM method, but not limited by it. The authors have come to understand that there are essentially no valid categories of disorders but a spectrum of conditions.
Our method therefore, measures many symptoms, but counts them not in order to categorize but to give a perspective on the nature and severity of the condition.
In addition to the standard mental status exam, we use three quantitative measures. These help us understand a person initially and then measure progress. State measures are a way to understand how a person’s current condition: esp about emotion(s).
1) Vital signs include heart rate, blood pressure, respiratory rate, and oxygen saturation. Measuring these provides a foundational snapshot of your physical health and helps us understand how your body responds under stress, during relaxation, and in daily life. These metrics can indicate physical contributors to symptoms such as anxiety or depression.
2) Heart rate variability measurement provides useful information to understand (Autonomic) Nervous System balance and keep track of progress. Heart Rate Variability measures the variation in time intervals between heartbeats. HRV reflects how your autonomic nervous system (the system controlling stress and relaxation) functions. High HRV typically indicates healthy resilience to stress, while low HRV can suggest chronic stress, anxiety, or burnout. Tracking HRV helps monitor your response to treatments like TMS, tDCS, mindfulness, and psychotherapy.
3) Galvanic Skin Response measures changes in skin conductance linked to emotional and physiological arousal. Increased skin conductivity is often associated with heightened anxiety or stress. By observing these subtle changes, we gain insights into your emotional states and physiological reactions, enabling more targeted approaches to stress management and emotional regulation therapies.
The Electroencephalogram (EEG) is a well-established, non-invasive test that records electrical activity in your brain—often referred to as brainwaves. EEG has a rich clinical history, invented more than 100 years ago and extensively validated through decades of research.
In 2013, EEG technology reached an important milestone when the FDA approved the use of EEG for diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) by measuring a specific pattern known as the theta/beta ratio. This marked a major advancement in using EEG objectively to guide psychiatric diagnoses and treatments.
Beyond ADHD, recent published studies suggest that measuring a person’s individual alpha frequency—the specific brainwave frequency unique to each person—can significantly enhance the effectiveness of brain stimulation therapies. Rather than stimulating everyone’s brain at the same frequency, identifying and using an individual’s unique alpha frequency may lead to improved outcomes in treating conditions like depression and anxiety.
EEG brain imaging visually represents brain activity measured at the scalp. Typical EEG maps show circles representing the head with the nose pointing upward, where colors like red indicate higher brainwave activity, and blue indicates lower activity. Advanced techniques, including the Fourier Transform, allow us to examine brainwave frequencies between 0.1 Hz and 50 Hz. These frequency analyses help identify if a person has a clearly defined alpha peak—crucial information for customizing effective treatments.
At our clinic, we utilize EEG data collected through state-of-the-art tools such as:
• Emotiv EPOC: A comfortable, wireless EEG system that captures brainwave data for sophisticated analysis in software like EEGLab/MatLab.
• NEBA system: An FDA-approved wired EEG specifically designed for assessing ADHD through automatic analysis of the theta/beta ratio. NEBA provides a streamlined diagnostic process by sending your EEG data to experts who analyze and quickly return comprehensive reports.
By leveraging these advanced EEG tools, our clinic offers precise, personalized treatment plans, significantly enhancing mental health outcomes for our patients.
In some situations, it might be beneficial for us to review additional information, such as previous treatment records, laboratory results, imaging studies (X-ray, CAT scan, MRI, SPECT scan, etc.), or neuropsychological testing.
If these are required, we’ll help you obtain them. However, if you already have these records and can conveniently bring them to your first visit, you’re encouraged to do so—but please don’t delay your first appointment gathering this information. Come as you are. Our comprehensive diagnostic system is specifically designed to gather the most accurate, detailed information from your current status. In fact, about 90–95% of the time, prior treatment information from other sources isn’t necessary. The sooner we start, the sooner you’ll feel better.
Your privacy and confidentiality are our highest priority. Everything you share with us is kept strictly confidential to the fullest extent allowed by law. No information will ever be shared without your explicit request and permission.
3) Galvanic Skin Response measures changes in skin conductance linked to emotional and physiological arousal. Increased skin conductivity is often associated with heightened anxiety or stress. By observing these subtle changes, we gain insights into your emotional states and physiological reactions, enabling more targeted approaches to stress management and emotional regulation therapies.
