DrJBHL DrJBHL

Hope for people with treatment resistant Major Depression

▼

Hope for people with treatment resistant Major Depression

from JoeUser Forums

 

Many folks have asked for “medical stuff” (enough computer viruses how about human ones?) so, this is about some gadgetry which has caused an earthquake in the treatment of depression.

Many folks have episodes of Depression through their lives, tied to events or not. In most, they resolve without the need for intervention. In many though, medications (thank G-d for them) are needed (and they work well for most, Mr. Cruise). They aren’t uniformly successful, and can cause problems (occasionally severe). They often need change, and for those in whom they failed, or caused other problems only behavioral therapy or ECT (electro-convulsive shock) remained as possibilities.

Now there’s something new: DBS (Deep Brain Stimulation). This form of therapy was initially found for movement disorders (Parkinson’s disease, and the like), and experimentally for anti-pain treatment.

In this form of treatment, electrodes are placed by a Neurosurgical team in problem areas. These devices work very similarly to heart pace makers: There’s a battery and miniprocessor (externally programmable) and electrodes (single or double) on wires placed beyond the problem area of electrical blockage. Some of these devices also function as defibrillators.

So, what does it look like?

Just like that.

Where does it go? In Brodmann Area 25 which is a sort of “conduit” of fibers going from the frontal lobe to the limbic area (regular and in 3D from the Wikipedia):

 

 

Graphically:

 

And in real life:

 

So, the patient is mildly sedated during the procedure and as electrodes are stimulated, describes his/her feelings. Various electrodes along the wire are stimulated until a helpful one is found. The generator is then programmed and placed under the skin (just like a pacemaker) and wires run under the skin to a connection point (in the xray, the four horizontal bars).

So…. As requested… some medical stuff.

Sources:

https://en.wikipedia.org/wiki/Brodmann_area_25

http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=12999&cn=5

http://psychcentral.com/blog/archives/2006/10/11/area-25-may-help-the-severely-depressed/http://www.medicalnewstoday.com/releases/106460.php

http://www.empowher.com/depression/content/depression-and-brodmann-area-25

http://psychcentral.com/news/2008/06/27/new-study-of-dbs-for-depression/2518.html

106,624 views 46 replies
Reply #26 from WinCustomize Forums Top

Quoting Jafo, reply 24
Only 'problem' is that some of the world's most 'creative' minds have been depressed and/or suicidal, etc. 'Kill' the 'disease' and bang goes their creative artistry.
End of Jafo's quote

I think that is what Aldous Huxley was saying in "Brave New World."  I remember reading that book and thinking "This is no dystopia!  This is a wonderful society" but then I got to the part where art and poetry and music were obliterated because there was no need for them, because everyone being happy and productive, and there was no muse, no stimulus to be creative for.

Reply #27 from WinCustomize Forums Top

Quoting Vampothika, reply 4
i find with my bipolar... when im depressed, andy takes me outside for a stroll around our town... works wonders..

plus i hate being stuck indoors 24/7 its not healthy for anyone...
End of Vampothika's quote

 

I take so many darn drugs I have to work to be depressed - or just not take the drugs. Drugs keep me mellow but unwilling to go or do anything in the real world unless chased out. No drugs and I'm manic, depressed, and subject to paranoia and panic attacks. I would give anything to be off the drugs. Being up 24 hours a day leads to a lot of computer productivity, but on the other hand the depression could be a killer and so could the extreme anger coupled with the knowledge of how to really hurt people. So, I'm stuck with drugs. Having a gadget stuck in my head would be far less side effects than the long term effects of the chemicals.  Because of my health, I can see both sides all to well.

 

Galactic Civilizations III
Reply #28 from WinCustomize Forums Top

Quoting Jafo, reply 24
Only 'problem' is that some of the world's most 'creative' minds have been depressed and/or suicidal, etc.  'Kill' the 'disease' and bang goes their creative artistry.

Simple test....see if you can list ALL of the British comedians who WEREN'T cronically depressed and/or suicidal....

 

Then there's all those musicians that have taken themselves 'out' with illicit and/or prescription drugs.....
End of Jafo's quote

That really isn't a proven fact... no one has demonstrated a loss of creativity or humor by easing depression... of course, on the other hand, how many have committed suicide, and was laughing at a joke really worth that price?

Quoting LizMarr, reply 27
I can see both sides all to well.
End of LizMarr's quote

Lizmarr, that is a different problem. Sorry, but the DBS won't fix that. ;)

On the other hand, you have five fingers.  ;)  

[see? no DBS and you smiled - I hope].

Reply #29 from WinCustomize Forums Top

Quoting DrJBHL, reply 28
On the other hand, you have five fingers.
End of DrJBHL's quote

X|   (insert Worf gif here) 

Reply #30 from WinCustomize Forums Top

I know it won't fix that. It was an argument about why a gadget would be better than all the other stuff someone with a mental illness goes through. Where I used to work I would say half of the people we admitted were off of their meds. They got to feeling well and kinda forgot to take them for a while. This was long term depression to schizophrenia and all steps in between. Once they were there for a bit and back on their meds they were another person altogether. Sometimes in as short as three days they were going back home (with a firm scolding by doctors and nurses alike about taking drugs) Reminding me to take my drugs is one of the things my service dog is trained for.

Such a device even if it is only one condition that it helps at this time, would take strain like this off of the medical system. Not to mention what joy it would be to not worry about taking drugs and their cost (one of mine is $600 per month and I have no insurance, the company that makes it gives it to me)

Reply #31 from WinCustomize Forums Top

Quoting DrJBHL, reply 28
That really isn't a proven fact... no one has demonstrated a loss of creativity or humor by easing depression...
End of DrJBHL's quote

Yet.

 

Looks like 'mother's little helper' now has batteries included....;p

Reply #32 from WinCustomize Forums Top

Quoting Jafo, reply 31

Quoting DrJBHL, reply 28That really isn't a proven fact... no one has demonstrated a loss of creativity or humor by easing depression...

Yet.

 

Looks like 'mother's little helper' now has batteries included....
End of Jafo's quote

Indeed, Mick. ;)

 

Some folks have brain chemistry problems not easily solved... if all else fails, this device might help. Better than sponginging the pavement, and much is gained by easing suffering.

Quoting Jafo, reply 31
Yet.
End of Jafo's quote

That type of argument cannot be answered except with "tincture of time".

Reply #33 from WinCustomize Forums Top

Doc...not necessarily....not when the incidence of mental 'issues' amongst the creative appears to sit well outside any reasonable bell-curve....;)

 

Reply #34 from Stardock Forums Top

Jafo - while being an artist can lead to loneliness, the depression rate amongst successful ones (including authors, artists and entertainers) is low. Supposedly.

Perhaps it has to do more with inherited risk (genetics), duration of stress and its severity, and availability of support. 

At any rate, I can't find any 'real' data to look at, only pseudo-scientific studies. The closest to data is http://www.samhsa.gov/data/NSDUH/2k10NSDUH/2k10Results.htm#High .

I think we'll have to shelve it until real data based on reliable sampling and criteria is done and analyzed by real statisticians. Otherwise we're dealing with the phenomenon of 'iceberg tips' - famous people get noticed and written about, not the 90% under water, and unseen... Titanic's Captain could elucidate that better than I.

Reply #35 from WinCustomize Forums Top

Quoting Jafo, reply 24
Only 'problem' is that some of the world's most 'creative' minds have been depressed and/or suicidal, etc. 'Kill' the 'disease' and bang goes their creative artistry.

Simple test....see if you can list ALL of the British comedians who WEREN'T cronically depressed and/or suicidal....
End of Jafo's quote

the same can be said for many US comedians as well....

I've often wondered if the likes of John Cleese, Peter Sellers, Spike Milligan etc... would have swapped their affliction for a normal life... I actually doubt it...

 

Man goes to doctor. Says he's depressed. Says life seems harsh and cruel. Says he feels all alone in a threatening world, where what lies ahead is vague and uncertain. Doctor says the treatment is simple. The great clown Terrifini is in town tonight. Go and see him. That should pick you up. Man bursts into tears: "But doctor . . . I am Terrifini."

The Tears of a Clown:  Comedians & Depression....        

Jim Carrey's battle with depression..

 

interesting read...

I suppose you have the comedians born genetically prone to depression....and those whose depression is bought about by childhood abuse/tragedy.... would Billy Connolly be the comedian he is today if he had had the perfect childhood...   :|   guessing.....nup..

 

Reply #36 from WinCustomize Forums Top

Quoting sydneysiders, reply 35
Man goes to doctor. Says he's depressed.
End of sydneysiders's quote

Here's some efficiency (G-d bless the man):

Though it might give me a scare to see a Neurosurgeon dressed that way.

 

Reply #37 from WinCustomize Forums Top

Dr. JBHL...

Since this is device is also controlled by a magnet I wouldn't be able to have it implanted because of the VNS since it is controlled by a magnet. I am curious though... Since my Epilepsy causes a very bad temper and anti depressants are being taken to control it... can this help with the temper of Epilepsy and the depression that comes with MS since I also have MS? Have there been any studies done with this helping people with temper issues involving seizures and depression  involving MS?

Reply #38 from WinCustomize Forums Top

Quoting LizMarr, reply 27
I take so many darn drugs I have to work to be depressed - or just not take the drugs. Drugs keep me mellow but unwilling to go or do anything in the real world unless chased out. No drugs and I'm manic, depressed, and subject to paranoia and panic attacks. I would give anything to be off the drugs. Being up 24 hours a day leads to a lot of computer productivity, but on the other hand the depression could be a killer and so could the extreme anger coupled with the knowledge of how to really hurt people. So, I'm stuck with drugs. Having a gadget stuck in my head would be far less side effects than the long term effects of the chemicals. Because of my health, I can see both sides all to well.
End of LizMarr's quote

 

i stopped taking meds years ago... i felt NOTHING... nothing worse than feeling nothing...

cant feel anger, cant feel sadness, cant cry, cant feel happy..just nothing

plus my whole body felt like a wet bag of cement...could barely move..

no thanks....

but i still see the whole bi polar thing as a curse....no matter what. BUT i do try my best to fight it and win over it and thats what matters in the end i guess..

Reply #39 from WinCustomize Forums Top

I understand all too well going off all the medication because they would knock me out and I would sleep all the time. That includes the seizure drugs. I would then pay the price with another bad grand mal seizure and get badly hurt along with a worse temper and depression and now the MS and depression that goes along with that. I've learned through experience that without the medication a price is paid and it is a very high one.

I always said that I would never have brain surgery to try and take out the seizure focus if they could because if could come back and brain surgery is dangerous. But I have changed my mind and went through it twice to see if I would be a candidate for it. I'm not because that's when they found the MS the second time around in 2008. If I didn't have the VNS... I think I would definitely try for this implant.

Reply #40 from WinCustomize Forums Top

Quoting TheCatsMeowMix, reply 37
Dr. JBHL...

Since this is device is also controlled by a magnet I wouldn't be able to have it implanted because of the VNS since it is controlled by a magnet. I am curious though... Since my Epilepsy causes a very bad temper and anti depressants are being taken to control it... can this help with the temper of Epilepsy and the depression that comes with MS since I also have MS? Have there been any studies done with this helping people with temper issues involving seizures and depression  involving MS?
End of TheCatsMeowMix's quote

I honestly don't know, but it's being used in such a small population at this point I'd be hard pressed to draw any but anecdotal conclusions.

Sorry :(

Quoting Vampothika, reply 38

Quoting LizMarr, reply 27I take so many darn drugs I have to work to be depressed - or just not take the drugs. Drugs keep me mellow but unwilling to go or do anything in the real world unless chased out. No drugs and I'm manic, depressed, and subject to paranoia and panic attacks. I would give anything to be off the drugs. Being up 24 hours a day leads to a lot of computer productivity, but on the other hand the depression could be a killer and so could the extreme anger coupled with the knowledge of how to really hurt people. So, I'm stuck with drugs. Having a gadget stuck in my head would be far less side effects than the long term effects of the chemicals. Because of my health, I can see both sides all to well.

 

i stopped taking meds years ago... i felt NOTHING... nothing worse than feeling nothing...

cant feel anger, cant feel sadness, cant cry, cant feel happy..just nothing

plus my whole body felt like a wet bag of cement...could barely move..

no thanks....

but i still see the whole bi polar thing as a curse....no matter what. BUT i do try my best to fight it and win over it and thats what matters in the end i guess..
End of Vampothika's quote

Some meds unfortunately have that effect... since then though, newer ones are around (takes trial to see...) which don't have that type of effect... that said, many bipolar patients resist treatment because the energy they feel when 'up'.

Quoting TheCatsMeowMix, reply 39
I've learned through experience that without the medication a price is paid and it is a very high one.
End of TheCatsMeowMix's quote

When such possibly potentiating diseases co-exist, it's very hard to know where symptoms are coming from. I really think you should consult with your Neurologist about this problem, and ask him the questions about whether having two such devices is really a problem or not. The magnetic fields used to program them are nowhere near the strength of MRI signals, and the battery/generators can be placed far apart.

As for brain surgery, Lizmarr... the surgery to remove an epileptic focus can generate a scar which might create an epileptic focus as well.

Reply #41 from Elemental Forums Top

I've had several encounters with depression... today, but shoving wires into my head, although it sometimes seemed like a good idea as any, doesn't seem so appealing when I'm lucid.

 

 

Reply #42 from WinCustomize Forums Top

unacomm.... no one offered. It's just something to know about if you're ever in a jam, and... don't try this by yourself at home.  :grin:

Reply #43 from JoeUser Forums Top

ECT (much improved in technique) has been making a quiet comeback and has been proving to be very beneficial in resistant cases.  Still very much under the radar because of its historical (mis)application, depending on how you look at it.  The principal advantage over an implanted device is that future potential need for diagnostic MRI is not impacted.

Reply #44 from WinCustomize Forums Top

Quoting Daiwa, reply 43
ECT (much improved in technique) has been making a quiet comeback and has been proving to be very beneficial in resistant cases.  Still very much under the radar because of its historical (mis)application, depending on how you look at it.  The principal advantage over an implanted device is that future potential need for diagnostic MRI is not impacted.
End of Daiwa's quote

Also correct. Also true re: CT. The DBS should really only be used for ECT resistant cases or those for whom another medical condition presents a contra-indication or is unacceptable for some other reason. 

Reply #45 from JoeUser Forums Top

Quoting DrJBHL, reply 17
1. It changes the brain chemistry using electricity - just like the brain (and any tissue which maintains a potential difference does).

2. It does not "force" anything. Depression "forces" problems. The patient isn't turned into a grinning idiot.

3. About EMR? If strong enough, it will cook anyone with or without a medical device.

 
End of DrJBHL's quote

1. No, it changes it differently to how the brain does it. If brain cells are shocking each other you have a serious case of Myelin decay. Nerve cells communicate via chemicals in the synapse. Electrical impulses are used WITHIN individual cells through the Axon.

https://upload.wikimedia.org/wikipedia/commons/a/a9/Complete_neuron_cell_diagram_en.svg

https://en.wikipedia.org/wiki/Axon

2. It does force things, I explained what. Depression is harmful, yes, if only this solved depression. Strawman argument about the grinning idiot.

3. IF strong enough it will vaporize a city (99% of the energy released by nuclear bomb is EMR which rapidly converts to heat as it contacts the air and solids around the epicenter; if exploded in low orbit it instead converts into an EMP).

But you are more keen to throw hyperboles then actually discuss an issue.

4. Nice picking and choosing, but this will simply not work effectively.

Reply #46 from JoeUser Forums Top

Quoting Sinperium, reply 18
There is a HUGE amount of research driving this sort of invention that has NEVER been seen before.
End of Sinperium's quote

Yes there is.

The research focus for the past few years on Alzheimer's, Parkinsons, Creutzfeldt–Jakob's Disease, ADD/AAHD as well as depression studies, endocrinology and even the fields of artificial intelligence, neural sciences and cybernetics have synergistically started to dovetail together and are providing huge amounts of very precise data on how the brain and nervous system work.
End of quote

Very fancy statement saying very little.

It is the first time we have ever had the technological tools to actually map and experiment real-time with the brains multifaceted processes--electromagnetic, hormonal, etc.--while it is working.
End of quote

Actually fMRI has dominated brain researching since the early 1990s and has been available longer.

https://en.wikipedia.org/wiki/Functional_magnetic_resonance_imaging

This isn't like the days when we used tap hammers to drive metal rods into people's brains to see if it might help.  We can now watch in real time the molecular, chemical and physical changes happening in the brain as we interact with it.  The understanding of the brain is greater than it has ever been in history and this may be one of those watershed moments where whole new realms of treatment and cure become available.

Depression is one of the biggest issues because it affects everyone in the world and there are so many areas affected by it and causal to it that a lot of information and research is needed.  If you have ever known anyone "chemically lobotomized" as the means of managing their symptoms, you'd understand why any sort of experiment that might give hope is worth it to a lot of people.

End of quote

https://en.wikipedia.org/wiki/Neuroplasticity

So by pointing out that this is a dangerous ineffective procedure I am suddenly the bad guy trying to steal hope from people suffering from a serious malady for the evulz?

Has it occurred to you that maybe I am concerned for their health? I admit to not being a full blown neurologist but I have take some advance level neuroscience classes on my path to finishing my BS in Molecular Biology. Yes I am not an expert but I am not talking out of my ass here either.

There are serious issues with this kind of treatment which I have outlined and they should not be ignored in the name of hope. Research is fine, promising a cure is going a lot further then just research though.

https://en.wikipedia.org/wiki/Desensitization_(medicine) is a big deal. If you drink cofee, then within as little as 1 week your baseline has dropped so much that 1 cup of coffee in the morning only brings you back to what your baseline was without coffee a week before. (unusually with coffee, it actually allows resensitization, takes about 10 days of abstaining from coffee to get back to normal).

This brain pacemaker is EXPLICITLY described as working by being calibrated based on asking the patient how they feel when a charge is applied to different parts of their brain. When the desired feeling is found it is programmed to deliver regular stimulation to that location. This is pretty big because the constant stimulation of a single zone WILL cause desentization (which, worse, occurs via programmed cell death) and it does not treat the underlying CAUSE of their depression, only forces enough "positive" emotions to alter overall emotion.

Finally, existing medicinal brain implants suffers from causing scar tissue to form on contact point ruining their effectiveness over time. This needs to be solved before this is a viable treatment alternative.

Personally I believe the cause of the scar formation is due to applying gross charges, we need nanotech implants capable of stimulating individual cells with neurotransmitter chemicals. Direct electrical stimulation is dangerous to the cell since it works via a cascade of ions penetrating the membrane and undoing the electrical gradient which cells set up between their inside and outside across the cell membrane, done in effect to create a battery which is also crucial to the functionality of the cell including ATP production.