The science of mental health is still in its infancy, given that lobotomy was considered a viable treatment for many psychological illnesses just a few decades ago. We don’t even know why some psychiatric drugs work. Like our understanding of internal brain processes, it may become possible to treat disorders not with drugs but with direct stimulation of the brain. One patient, the subject of a recently published study on the treatment of depression, can attest to this. The patient, known as Sarah, says her depression was relieved with direct brain stimulation via implanted electrodes.
Direct brain stimulation (DBS) has been used in the treatment of Parkinson’s disease and certain seizure disorders. Electrical impulses from DBS can alter erratic patterns of brain activity, causing changes in mood or behavior. Figuring out exactly where to change brain activity is a challenge, however.
Sarah has reportedly suffered from severe depression since childhood and none of the treatments she sought had a substantial impact. The method used by the team at the University of California began by assessing the patient’s brain activity for patterns of activity that may be associated with depression. Then, the team regulated the electrical impulses that would be introduced into the patient’s brain.
The researchers found that Sarah’s brain showed spikes in activity in the ventral striatum, which is part of decision making. There were also dysfunctional patterns in the amygdala, which regulates emotional responses like fear and anxiety. According to Sarah, the difference was immediately noticeable when the initial test device was activated. As her depression started to worsen again while she waited for the DBS implant to be ready, her recovery has been abrupt since the surgery. She says she finally feels able to “rebuild a life worth living”.
While this news may give hope to many people with hard-to-treat depression, the team is careful to stress that this is not a quick fix. It is a one-off success that could pave the way for new treatments. For this to be viable, the process will need to be streamlined. Sarah’s analysis and treatment planning was labor intensive – the cost could easily exceed $ 30,000. Further research is needed to fully understand the implications and function of DBS for treating severe depression. However, invasive brain surgery will probably never be the preferred treatment for depression. Like ECT, such drastic treatments are likely to be a last resort, or almost a last resort. Members of the team are already studying ways to stimulate the brain in a non-invasive way.
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