Brain Research Offers Hope Different Approaches to Treat Depression
BYLINE: Kate Kelland l ADD A CHEMICAL AND STIR? l ELECTRO-THERAPY l DEEP BRAIN STIMULATION
LONDON: As Susan sits chatting to a nurse in a London clinic, a light tapping sound by her head signals that parts of her brain are being zapped by thousands of tiny electro-magnetic pulses from a machine plugged into the wall.
The 50 year-old doctor is among growing ranks of people with so-called treatment-resistant depression, and after 21 years of fighting a disorder that destroyed her ability to work, and at times made her want to "opt out of life", this is a last resort.
Until recently, Susan and others like her had effectively reached the end of the road with depression treatments, having tried the best drugs medical science had to offer, engaged in hours of therapy, and tried cocktails of both.
But a renaissance in research on depression prompted by some remarkable results with highly experimental treatments has changed the way neuroscientists see the disorder and is offering hope for patients who had feared there was nowhere left to go.
Their drive to find an answer has taken neuroscientists to uncharted waters, researching everything from psychedelic magic mushrooms to the veterinary tranquilliser ketamine, to magnetic stimulation through the skull, to using electrical implants - a bit like a pacemaker for the brain - to try to reset this complex organ's wiring and engender a more positive outlook.
Their sometimes surprising findings have in turn taught them more about depression, leading to a view of it not as a single mental illness, but a range of disorders each with distinct mechanisms, yet all producing similarly debilitating symptoms.
"The thinking about depression has been revitalised," said Helen Mayberg, a neurologist at Emory University in Atlanta in the US.
"We have a new model for thinking about psychiatric diseases not just as chemical imbalance - that your brain is a just big vat of soup where you can just add a chemical and stir - but where we ask different questions: what's wrong with brain chemistry and what's wrong with brain circuits?" - Reuters
There's little doubt that until this new breath of hope, depression had been going through a bad patch.
Affecting more than 350 million people, depression is ranked by the World Health Organisation as the leading cause of disability worldwide. In extreme cases, depressed people kill themselves. About a million people commit suicide every year, the majority due to unidentified or untreated depression.
Treatment for depression involves either medication or psychotherapy and often a combination of both. Yet as things stand, as many as half of patients fail to recover on their first medication, and about a third find no lasting benefit from any medication or talking therapy currently available.
High hopes for "wonder" drugs like Prozac, Seroxat and others in their class of selective serotonin reuptake inhibitors (SSRIs) in the 1980s and 1990s were dimmed by studies in the 2000s that showed they helped a proportion of people, but left at least 30 percent of patients little or no better than before.
And as chronically depressed patients move from trying one drug to the next, or one type of therapy to another, their hopes dim as it becomes clear that failing to get better with each depressive bout in turn also ups their chances of relapse.
For Susan, the battle seemed never ending. When she was at her lowest, she dreaded each day, says she was "frightened of everything" and overwhelmed even by straightforward tasks like making a meal for her two children. …