Deep Brain Stimulation as Depression Treatment

Neopallium writes "Medtronic, today announced its intentions to pursue a major clinical trial of the company's deep brain stimulation (DBS) technology in the treatment of severe and intractable depression, a disabling form of the psychiatric disorder affecting millions of people worldwide. "While not a cure, DBS has allowed these patients to return to much more functional and happy lives," said Dr. Rezai, who represented an international working group of physicians that has been studying the application of DBS therapy in the treatment of intractable depression and OCD in collaboration with Medtronic."

Comments

Re:Unexpected side-effects

[0racle]

How depressing ...
They can fix that now.

The Original Clockwork Orange

[Baldrson]

Anthony Burgess, author of the book "A Clockwork Orange" was the artist in residence while I was in the undergraduate program at the Iowa City Writer's Workshop back in 1974. I think he based his book on the work of Jose M.R. Delgado, M.D. published under the book with the damn spooky title: "Physical Control of the Mind: Toward a Psychocivilized Society".

I managed to get a copy of the book finally, and discovered wonderful passages such as the following on page 115:

ESB [electrical stimulation of the brain -- JAB] may evoke more elaborate responses. For example, in one of our patients, electrical stimulation of the rostral part of the internal capsule produced head turning and slow displacement of the body to either side with a well-oriented and apparently normal sequence, as if the patient were looking for something. This stimulation was repeated six times on two different days with comparable results. The interesting fact was that the patient considered the evoked activity spontaneous and always offered a reasonable explanation for it. When asked, "What are you doing?" the answers were, "I am looking for my slippers," "I heard a noise," "I am restless," and "I was looking under the bed." In this case it was difficult to ascertain whether the stimulation had evoked a movement which the patient tried to justify, or if an hallucination had been elicited which subsequently induced the patient to move and to explore the surroundings.

This passage is eerily reminiscent of a passage from Richard Dawkins' "The Extended Phenotype" chapter titled "Host Phenotypes of Parasite Genes":

"Many fascinating examples of parasites manipulating the behavior of their hosts can be given. For nematomorph larvae, who need to break out of their insect hosts and get into water where they live as adults, '...a major difficulty in the parasite's life is the return to water. It is, therefore, of particular interest that the parasite appears to affect the behavior of its host, and "encourages" it to return to water. The mechanism by which this is achieved is obscure, but there are sufficient isolated reports to certify that the parasite does influence its host, and often suicidally for the host... One of the more dramatic reports describes an infected bee flying over a pool and, when about six feet over it, diving straight into the water. Immediately on impact the gordian worm burst out and swam into the water, the maimed bee being left to die' (Croll 1966)."

possible spam

[William Robinson]

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Re:There are a few loose ends....

[Cicero382]

Right! The glib tone of this post annoys me; I can't let it go by without comment.

Before I start, both I and my wife suffer from chronic depression (and I'm bipolar). We both lead perfectly normal and happy lives - thanks to medication. So I know what I'm talking about.

> 2. Shock treatment (as in for the loonies)

Oh, thank you very much! I haven't had this, but my wife was so desparate that she did. I can't say whether it cured her (I suspect the medication has much more to do with it), but I *can* say that it is a brutal approach. I refused because I was afraid that it would damage my mind (which is a very good one - polymath). It tore her mind to bits! For months after the sessions she was confused, had massive memory loss (and those memories are gone for good) and suffered - possibly more than the depression itself. I think that one could compare it to resetting a computer by throwing a bucket of water over it. Quite possibly, its only effect is to press RESET on the brain and let it rebuild from there.

> but spend more time on the down side

Actually, the "up" side is even worse. You can do serious damage to yourself and those around you, mentally, spiritually, financially and even physically. At least when you're "down" you tend to stay put. Not that it's much fun.

> 3. Regardless of the treatment, many seriously believe "fixing" this, particularly the down or
> depressed side will decrease or neutralize the creative side of those who are exceptionally
> creative.

There is something in this, but it misses the point. People who want to mitigate the effects of the medication for any reason don't have *severe* depression. If you do, you will do ANYTHING to make it stop... and I mean *ANYTHING*. Why do you think sufferers kill themselves? In a way, I'm lucky because my disease started at an early age and built to a crescendo by the time I was 30. If I (or, I suspect, anyone) suffered the full effects in one go I would have looked for the very first way to kill myself - immediately.

I do suffer some performance hit from the medication, but it's worth it. I once tried to get a boost for an important problem by stopping my medication. Never again!

If you're a sufferer, don't worry about this. It really is fairly minimal and, as I said, very well worth it. Look at it this way; if you don't have to spend most of your mental energy fighting it, you're more productive anyway and much happier as well. In the course of my treatment, they concentrated on mitigating the symptoms, then hunting round for the correct drug and dosage for everyday life. It works very well.

Finally, don't be ashamed. I know that there's a lot of stigma attached to depression and OCD but were you ashamed when you had a cold? Of course not! And it's the same thing - a disease. And it can be treated. If you have it, get help NOW! There is no need to suffer. It will take time and patience, but it can work.

And, finally, finally: Remember you're not alone. Many others know how you feel (me, for example) and love and understanding can go a *long* way (soppy, but true). Where do you think my wife and I met? Yup - the loony bin (*I* am allowed to say it :) 15 years now (happy sigh).

Re:Unexpected side-effects

[wazzzup]

It's not about fitting in or creating a socially acceptable human being through chemistry. It's about relief from the prison of your mind.

As someone that suffers from bouts of major depression and obsessive-compulsive disorder (OCD), if the treatment leaves me in a state of being "a bit off" but in a state where I can function in day-to-day society - that's okay.

Without treatment, I'm prone to lie in bed all day barely able to speak (the depression) while my mind (figureatively) straps me in front of an IMAX screen and makes me visualize horrible things like blowing my brains out over and over again, throwing my son off a cliff, being gang-raped and other lovely sunny-day thoughts (the O in OCD). Obsessive thoughts are completely unwanted (they don't indicate some subconcious desire) thus feeding the depression which, in turn, makes it harder to block the obsessive thoughts. In my case, I wasn't hurting others (except my family who had to watch me go through those episodes) but I was hurting myself.

While I don't think we should strive for a Stepford Wives kind of norm through medication, the medication is a godsend - not an Orwellian mind-control tactic. While you or someone else may think "so they're odd - leave them alone, it's who they are" it's *not* who they are. Who they are has been dominated and replaced by the condition/disease. I completely understand why someone that has not experienced mental illness might see things in the manner you describe. In fact, most people with mental illness won't tell thier friends or peers about thier condition because of the social stigma that mental illness carries.

With treatment, sure there are days I'm "a bit off" but that's okay - no one's the wiser.

I guess what I'm trying to say is that, while "oddballs and eccentrics" might not be hurting anyone, they may, in fact, be hurting intensely within - wishing they could rid themselves of the oddness and eccentricity and become the person they really are. The oddness is just a small part of what surfaces to the outside world. That's not to say that all oddballs and eccentrics are mentally ill either and that's truly just who they are.

In regards to wondering whether these conditions are more prevalent than they were in the past - yes, based upon my personal research on the topic.

I hope my personal experience may have answered some of your questions.