http://www.psychiatryadvisor.com/depressive-disorder/utility-of-neuroimaging-in-depression/article/507297/

What Neuroimaging Can Teach us About Depression
Theodore Henderson, MD, PhD
July 01, 2016

Neuroimaging studies have shown several neurophysiological substrates for depression: An overview by Theodore Henderson, MD, PhD.

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Neuroscience and neuroimaging have revealed much to provide evidence that depression is a biological disease. Indeed, depression is not just one thing, despite the efforts of mainstream psychiatry to classify it into a single illness category. Nassir Ghaemi, MD, noted expert on psychopharmacology recently wrote:4

“Psychiatry…practice(s) non-scientifically; we use hundreds of made-up labels for professional purposes, without really getting at the reality of what is wrong with the patient…We have a huge amount of neurobiology research now to conclude that the 20th century neurotransmitter theories of psychopharmacology basically are false. The dopamine and monoamine (serotonin) hypotheses of schizophrenia and depression are wrong...we now know that drugs have major second messenger effects which (cause) neuroplastic changes in the brain, including connections between neurons. The brain is literally re-sculpted.”

Neuroimaging studies have shown several neurophysiological substrates for depression. Functional brain scans, such as SPECT (single photon emission computed tomography) or PET (positron emission tomography) have shown that while patients may present with the same symptoms of depression, they can have very different processes occurring in their brains.

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Future directions in Psychiatry might include anti-inflammatory agents,30 more extensive use of ketamine infusion therapy,33 ketamine analogs, and neuroimaging-based selection of medications,14,17 which some have shown improves outcomes.16 Recognition that depressive episodes can be precipitated by neural injury, such as TBI or toxic injury may lead to radically different, even non-pharmacological treatments for depression following brain injury. A barrier to these advances is the fundamental resistance on the part of psychiatrists to look at the organ they are treating and to open their eyes to possible alternative explanations for the depression the patient describes to them.

Theodore Henderson, MD, PhD, is a psychiatrist in Denver, Colo., who specializes in the diagnosis and treatment of complex adult, child, and adolescent psychiatric cases. His website is www.childpsychiatristdenver.com.