01 Nov Depression: Treatments on the cutting edge.
Depression: Treatments on the cutting edge.
It is normal to feel sad from time to time, but depression is different. It is a loss of ability to experience any pleasure and a loss of motivation that becomes disabling. It will strike up to 20% of people at some time in their lives.
Transcranial Magnetic Stimulation
Transcranial Magnetic Stimulation (TMS) is a technology that delivers magnetic pulses to the brain. It is a non-invasive treatment that is delivered via a helmet placed over the patient’s head or a paddle that is held over the scalp. It has been proposed as a treatment for a variety of maladies.
TMS has been FDA approved for treatment of Major Depression since 2007. It has more recently come into widespread use as medical insurers have agreed to pay for a course of treatment. For depression, the magnetic coils are positioned to activate the dorsolateral prefrontal cortex; an area of the brain that controls the highest level executive functions. (To read more about TMS, please see https://marcarginteanumd.com/can-a-magnetic-helmet-heal-the-brain-these-innovative-corporations-think-so/)
Deep Brain Stimulation
Deep Brain Stimulation (DBS) may be helpful in the treatment of drug resistant depression. DBS may be thought of as a pacemaker for the brain: Doctors insert a puck-shaped electronic device underneath the skin of a patient’s chest. Wires emanate from the device, which doctors thread through the skull into the deepest reaches of the brain.
Scientists have recognized that some patients that suffer from depression have malfunctioning of certain brain circuits and that the specific neurons (brain cells) involved may differ from patient to patient. In a 2021 study, scientists in California developed a paradigm where they study the electric signals from an individual’s brain to tailor a brain stimulation target that is unique to their situation. The doctors plan to target the abnormal neurons with DBS and electrically modify the brain of a depressed patient.
Some doctors have advocated the use of psychedelic drugs, especially in micro-doses, for the treatment of depression.
One study, published in 2021, suggests that music and psychedelics, used in conjunction, may have a place in the treatment of drug resistant depression. Danish scientists tested a combination of psilocybin (magic mushroom) And Mozart’s laudate dominum (https://youtu.be/q9rvyvssvuI) And Elgar’s enigma variations (https://youtu.be/sUgoBb8m1eE). They found that the combination of psychedelics and music increased wonder, transcendence and peacefulness.
Others have advocated for the use of THC, the psycho-active component of marijuana, in the treatment of depression. With marijuana legal in 18 states for recreational use and many others for medical use, people who suffer from anxiety, depression and insomnia are throwing away doctors’ prescriptions and self medicating in droves. The jury is still out as to whether they’re doing themselves good or harm, with researchers lining up on both sides. It will take time and a mountain of well designed scientific studies before we really know for sure.
Vagus Nerve Stimulation
Vagus Nerve Stimulation (VNS) is similar to DBS in that it may be considered a specialized pacemaker. However, the target of electrical stimulation is different. VNS targets a nerve in the neck (vagus nerve). Some physicians have employed VNS to treat major mood disorders such as depression that is resistant to drug and psychotherapy treatment.
Although VNS has been studied for more than 20 years, it is not clear that this treatment alone can alleviate depression in the long term. Recent research has suggested, however, that VNS, when combined with standard treatments may provide superior and durable results.