Non Pharmacological Approach for Depression and Other Disorders
Brain stimulation therapies:
Brain stimulation therapies are non pharmacological method which involves activating or touching the brain directly with electricity, magnets, or implants to treat depression and other disorders. Among many techniques, electroconvulsive therapy is the most researched stimulation therapy.
Other stimulation therapies discussed here includes
Vagus nerve stimulation
repetitive transcranial magnetic stimulation
magnetic seizure therapy
Deep brain stimulation.
The latter methods are newer and more theoretical.
1. Electroconvulsive therapy
Introduction:
It is a non pharmacological standard psychiatric treatment in which seizures are electrically induced in patients and thus the treatment is done.
ECT is reserved for cases of treatment resistant cases of major depressive disorder, schizophrenia, mania and catatonia
First developed in 1938, electroconvulsive therapy (ECT) did not gain popularity in the beginning. However, the procedure has improved significantly since its initial use and is safe and effective.
Source: http://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies.shtml
Uses:
It is used for the following purposes such as
• Severe, treatment-resistant depression
• Bipolar disorder
• Schizophrenia.
• Suicidal patients
• Severe depression.
Pre-requisite:
• Before ECT is administered, a person is sedated with general anesthesia.
• A muscle relaxant is also given to decrease the movement during the procedure.
• Vitals parameter like blood pressure, heart rate and respiratory rate should be monitored during the procedure.
Mechanism of action/Pr...
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...o reduce depression or OCD, scientists believe that the pulses help to "reset" the area of the brain that is malfunctioning so that it works normally again.
Side effects
DBS carries following risks
• Bleeding in the brain or stroke
• Infection
• Disorientation or confusion
• Unwanted mood changes
• Movement disorders
• Lightheadedness
• Insomnia
Long-term benefits and side effects are not reported.
Conclusion:
• Brain stimulation therapies are being used for treating the mental disorder not responding to usual treatment.
• Studies on rTMS are on progress.
• Other researchers are studying how the brain responds to VNS by using imaging techniques such as PET scans.
• Although DBS as a depression treatment is recent, researchers are are trying to find out its effectiveness and safety in treating OCD, depression and other mental disorder.
Unlike Naomi, Eric does not respond to drug therapy. Therefore, instead of a drug therapy, Eric receives the electroconvulsive therapy (ECT) or brain stimulation often an effective treatment for patients like Eric with severe depression who does not respond to a drug therapy. By shocking the brain, the ECT manipulates the brain’s chemical imbalance produced by the social-cultural stress experience. But after eleven ECTs in a month, Eric cannot function because of the temporary side effects of memory loss and confusion affecting his concentration to play the viola and his well-being. Then after four months of receiving ECT treatment, Eric returns to normal social functioning as a musician. Six months later, Eric is still playing the viola and has had no recurrence of his
Electroconvulsive therapy, also known as ECT, is a medical procedure that is used in the treatment of mental illness. In ECT, a small electrical impulse is sent through the brain, resulting in an ephemeral seizure. Though the process is generally effective, modern science is unaware of the explanation behind ECT's success. Its history is filled with a large amount of stigma and the use of ECT as a therapy is still debated today. ECT has evolved to a point where its beneficial effects can be maximized and its adverse effects can be minimized through proper administration.
According to the documentary, medicine is the most commonly used intervention mechanism to elevate and dull symptoms of bipolar disorder (2016). Of all the medicine used to combat bipolar disorder, lithium, is considered the “gold standard.” It has been shown to be the most effective and consistent and treating symptoms, however, only 30% of patients benefit from using lithium (2016). Other medications can be used, but have varying levels of effectiveness in patients. It often takes years for patients to find the right mixture of medication to help combat symptoms. For some patients with bipolar, medication is useless at fighting symptoms (2016). For example, the video followed Gary who was desperate for treatment and who was thought to be medication resistant. He elected to participate in Electro-convulsive therapy (ETC), which induces remission in 80% of patients and has been known to be rapidly effective for those with bi-polar disorder. For Gary, the treatment was used to apply electric current to the brain. This current changed the way neurons connect to one another in his brain and even stimulated the
... in assisting those who care about the bipolar individual, as well as providing socialization and a means to not feel alone. Generally, as a last resort, electroconvulsive therapy, or ECT is used. An electrical current is passed through the brain. This is thought to change the brain chemistry and increase the mood. This is used only for severe depression or when symptoms are unsuccessfully treated with medications. People with Bipolar Disorder are encouraged to avoid drinking alcohol, avoid the use of street drugs or misusing prescription medications, avoid unhealthy relationships, get plenty of sleep, and exercise on a regular basis. One thing is clear. The person themselves must be active in their own well-being in order to maintain a relatively healthy and productive lifestyle. In so doing, the prognosis for someone diagnosed with Bipolar Disorder is very good.
In the 1950s, Penfield tried to treat patients with epilepsy by using a mild electric stimulation to the brain. He thought the electric currents would trigger the cause of epilepsy allowing him to pinpoint and remove or destroy it. During his experimental surgery Penfield discovered that stimulation anywhere on the cerebral cortex could bring responses. He also discovered that
During the later part of the 19th century magents were used to induce neuronal activity; however, in the later part of the 20th century, Barker and his colleagues illustrated that magnetic stimulation in human motor cortexes produces depolarization of cortical areas (Eitan, & Lerer, 2006). TMS is a noninvasive therapeutic technique where an electromagnetic coil is put above the awake patient’s scalp and then magnetic pulses are moved throughout the brain (George, Lisanby, & Sackeim, 1999). The magnetic pulses and coil combine to create an electrical activity in the cortical tissue which can cause localized neuronal depolarization. Not only has TMS been the topic of many recent research studies, but deep transcranial magnetic stimulation (deepTMS) has also been researched to decipher the effectiveness for treating depression. DeepTMS is when the coils have been designed to create a more intense electrical field deep in the brain tissue. DeepTMS uses several separate points of projection around the periphery of the brain while minimizing the electrical charge to the br...
Guttmacher, L. B. (1994). Concise Guide to Psychopharmacology and Electroconvulsive Therapy. Washington: American Psychiatric Press Inc.
?What is the role of ECT in the treatment of mania?? Harvard Mental Health Letter. June 1997.
Electroconvulsive therapy, or ECT, is a highly effective yet controversial psychiatric method that involves sending electric shockwaves into the brain to cure various mental ailments. Because the populace is not typically educated by psychiatrists on techniques such as ECT, their knowledge comes from inaccurate, and mostly negative, descriptions in the media dictated by non-psychiatrists. Additionally, many patient families are skeptical of ECT because it is not common practice to allow non-medical staff in the therapy room. Furthermore, some psychiatrists perceive this treatment as callous because it is occasionally used without the consent of a patient, should they not be mentally stable. Moreover, because of strong public opposition, ECT
An individual who has a mental illness can be a danger to themselves and others. They don't live a normal life that is guaranteed to them, holding them back from being successful and having a bright future. If medications are not working for a mental illness, then the patient can consider electroconvulsive therapy. Electroconvulsive therapy (ECT) is a medical procedure that sends currents of electricity through your brain. ECT saves lives and is ethical to treat patients using “psychosurgical” procedure.
Paroxysmal rehabilitation was initiated in the early 1930’s in Europe by Ladislaus von Meduna as management for catatonic schizophrenia. Ladislaus generated seizures by the injection of camphor in oil but almost immediately interchanged camphor with metrazol because of its solubility and rapid onset of action. Also in 1934, Bini and Cerletti forged the use of electricity to persuade seizures. Electrical-induced convulsions were more prudent, inexpensive, and reliable than the camphor-induced convulsion.
One of the most controversial forms of treatment is electroconvulsive therapy. Electroconvulsive therapy, or ETC, is a procedure that consists of strong electric shocks that pass through the brain to induce convulsions (Vocabulary). This was a common method solve mental illnesses in the 1940’s and 1950’s. ECT was often criticized for not working and causing permanent memory loss (Mental Health America). Another dangerous and controversial diagnosis is Lobotomy. Lobotomy is a surgical procedure that interrupts the nerves in the brain (Vocabulary). It was very popular before prescription drugs and was also a common diagnosis of mental illnesses (Vocabulary.) The side effects include, but are not limited Mto; personality changes, empathy, inhibitions, inative, and the ability to function by themselves (Live Science.com). There was over 50,000 known lobotomies performed in the U.S., most were in mental hospitals (Live Science.com). Dr. Barron Lerner, a medical historian and professor at NYU Langone Medical Center in New York, told Live Science the science or thought process of lobotomy (Live Science.com). "The behaviors [doctors] were trying to fix, they thought, were set down in neurological connections. The idea was, if you could damage those connections, you could stop the bad behaviors (Live Science.com)." That’s why lobotomy
Several strides have been made in the medical field in regards to electroconvulsive therapy. The treatment is defined as “a medical procedure in which a brief electrical stimulus is used to induce a cerebral seizure under controlled conditions” (Enns, Reiss & Chan, 2010). It is used for a handful of mental illnesses, such as major depressive disorder, bipolar disorder, and schizophrenia, but when it was introduced in 1938 by Ugo Cerletti and Lucio Bin, its main use was to treat schizophrenia (Enns, Reiss & Chan, 2010). ECT can indeed be effective for schizophrenia, but the best results are when the “… duration of [the] illness is relatively brief or when catatonic or affective symptoms are prominent” (Enns, Reiss & Chan, 2010). Unlike schizophrenia, the best results from ECT have come from treatments with patients who have been diagnosed with major depressive disorder and alternative methods are no longer working...
In closing, the normal functioning of the brain and nervous system is vital for basic bodily functioning and processes. Injury, disease or abnormal structure of the brain will greatly affect one's behaviour, emotional regulation, mental processes and functioning. The brain will respond to any trauma, injury or abnormality to accommodate the dysfunction. During this response, the brain will physically change, the process called neuroplasticity, and attempt to "rewire" the brain to return to normal functioning. In the treatment of many cases as previously discussed, the aim was to reconnect neurons and the theory of neuroplasticity was the foundation behind it.
Payne, N.A. and Prudic, J. (2009) Electroconvulsive Therapy Part I : A Perspective on the Evolution and Current Practice of ECT Journal of Psychiatric Practice 15(5) pp.346-368