The science of mental health is still in its infancy, given that lobotomy was seen as a viable treatment for many psychological diseases just a few decades ago. We don’t even know why some psychiatric medications work. As our understanding of the brain’s internal processes, it may become possible to treat disorders not with medication but with direct stimulation of the brain. One patient, the subject of a newly published study on the treatment of depression, can attest to that. The patient, known as Sarah, says her depression was alleviated thanks to direct brain stimulation via implanted electrodes.
Direct Brain Stimulation (DBS) has found use in the treatment of Parkinson’s and certain seizure disorders. The electrical impulses in DBS can alter erratic patterns of brain activity, causing changes in mood or behavior. Figuring out exactly where to alter the brain’s activity is a challenge, though.
Sarah has reportedly suffered severe depression since childhood, and none of the treatments she sought had a substantial impact. The method used by the University of California team started by assessing the patient’s brain activity in search of activity patterns that could be associated with the depressive state. Then, the team tuned the electrical impulses that would be fed into the patient’s brain.
The researchers found that Sarah’s brain showed activity spikes in the ventral striatum, which figures in 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. While her depression did begin worsening again while waiting for the DBS implant to be ready, her recovery has been stark since the surgery. She says she finally feels able to “rebuild a life worth living.”
While this news could give hope to many suffering from difficult-to-treat depression, the team is careful to stress this is not a silver bullet. It’s a one-off success that could point the way to new treatments. For that to be viable, the process will have to be simplified. The analysis and planning for Sarah’s treatment was labor-intensive — the cost could easily surpass $30,000. More research will be necessary to fully understand the implications and function of DBS to treat severe depression. Invasive brain surgery will probably never be the preferred treatment for depression, though. Like ECT, treatments this drastic are likely to be last resorts or nearly last resorts. Members of the team are already investigating ways to stimulate the brain in a non-invasive way.
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