Deep Brain Stimulation and Depression

Imagine a world where medication didn’t exist.  Would people be better off? Medication has complicated our mind and bodies and there is no turning back.  When we don’t feel “normal”, we can run to our primary care doctor and demand that they prescribe us something to get us back on our feet.  But, what is “normal”? If medication were non-existent, would we be able to defeat whatever plagued us with our own mind and bodies?  Would whatever didn’t kill us, make us stronger? Would it make future generations stronger and more tolerable of these mind-altering states?

In today’s society, we often have a prescription for what is “normal”.  Today, if our mood or behavior deviates from our sense of normalcy, we put substances in our bloodstreams to alter the brain pathways to bring us back to this “normal state”.  As Andrew Solomon states in his article entitled “Anatomy of Melancholy”, “the use of anti-depressants is going up as people seek to normalize what used to be deemed normal”.  Solomon states that the physiological supermodel, like a real-life supermodel, has damaged our images of ourselves in that people are “constantly examining their own minds and rejecting their own moods”. He also states that there “needs to be recognition that what may well be a rising tide of depression is related to the fact that basic social and psychological needs are not being met”.  Solomon makes some excellent points.  But does this mean that there are basic needs that we must have met in order to feel “normal” or do we think that we must have these needs met in order to act in congruence to the normal-person model?

Solomon also raises the question as to whether antidepressants really function the way we think they function.  He poses the question, “Are they restoring the normal self or are they changing the self?” Like Solomon, people are often on many different medications for depression because the side-effects of one are numerous and dangerous, therefore, they need other medications to treat the side-effects.  I believe that these drugs are changing the self.  If we need to be sustained from multiple drugs, we have induced a state of dependence and have changed our brain pathways.

From our class discussions and readings on depression, I have become increasingly interested in the ways in which we ameliorate symptoms of depression without altering our brain chemicals.  Thus, I am excited about the idea of deep brain stimulation (DBS) as I have become skeptical of the anti-depressant method for treatment as the side effects are numerous and often dangerous.  The first news I found on DBS was that just a month ago, neurosurgeons at Heidelberg University Hospital performed DBS on a severely depressed patient and the procedure has proved to be successful! The patient was a 64 year old woman who had been suffering from depression since the age of 18 and had tried every medication and therapy in the book.  Today, she is free of those symptoms.

Helen Mayberg, a neurologist, discovered this “practice of putting electrodes into the brain and electrically stimulating at high frequency to calm abnormal hyperactive networks”.  She identified an area of the brain, known as Brodmann area 25, or the habenula, located in the diencephalon, that shows to be hyperactive in patients with depression. By stimulating this brain area, neurologists have shown to alleviate the symptoms of depression altogether.  I wonder if this cure will sustain over the course of one’s lifetime. Will DBS be the universal cure for symptoms of depression in the future?

For more information, check out these websites!

http://www.sciencedaily.com/releases/2010/01/100108101435.htm

http://www.dana.org/news/cerebrum/detail.aspx?id=12622

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7 thoughts on “Deep Brain Stimulation and Depression

  1. I wonder if that process for Helen was different from the one that Melissa was describing in class, because if I’m remembering right, Melissa said that they were interviewing the person who had just undergone the procedure and the effects took place pretty immediately but they would fade after a few minutes, so the switch/knob had to keep being adjusted. This might be different, though, because that was more of a pacemaker model I think, that would keep kicking in whenever necessary. I’ll try to find out more about that.

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  2. I think this is really interesting stuff. But I think your initial question was what caught my attention the most, where you ask what the world would be like without medication. Honestly, I think if we did not have medication, our world would be COMPLETELY different. I think we would be plagued with many illnesses and I think that we would live significantly shorter lives. What would this mean for humanity? I’m not sure. But I know that things would be completely different. If we were without medication, I honestly believe that we would see pure darwinism and natural selection, and people wouldn’t be as confused about why something happened, because that would be just the way it happens–no intervention available.

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  3. Really interesting idea. Your post got me thinking a lot. One question, in particular, sprung up:
    I’m curious, Sara, as to why you think DBS is a better treatment option than anti-depressants? Do you feel there is a stigma against anti-depressant pills that is worse than DBS treatment?

    One criticism I have is that while DBS is not a substance that alters targeted brain chemicals, it is also not a treatment that can “ameliorate symptoms of depression without altering our brain chemicals.” In order for an antidepressant treatment to work it needs to modify some chemicals in the brain. So, while DBS’s method of altering chemicals is different, the electrical impulses are still changing the brain chemistry to a varied state than before the treatment.

    I think that if DBS is accomplished in a controlled manner, it will definetly make a large wave for future treaments.

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  4. Awesome entry, Sara. Mayberg was one of the speakers at the Depression workshop I attended and she showed some pretty interesting data and videos.

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  5. I wonder what the world would be like without medication and I think of 100, 200, 300 years ago when people were sent away if they were “different” or if they would be shunned by society (such as a young girl single and pregnant). Although life might have been more simple and shorter then, was the quality of life better? It’s something you can never really compare because those who lived in the past would not have been happy here and we would not be happy living in the past.

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  6. Sara, I am so glad you bring up this idea of normal because I too think its so interesting. What always throws me for a loop is asking yourself what is “normal” if everyone has a different standard. In each culture normal is defined differently. For instance in Denmark it is completely “normal” to ride a bike in the snow to get to work, but if someone were to do that in Maine they may be considered a little crazy. When it comes to depression I think that Solomon makes good points we all want to get back to this standard but what if all of our standards are different?

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  7. Jenn and Jessie both make good points (as do you, Sara!), but I’m wondering if the beginning of your post is about how explicitly dependent we have become on medication. In the United States, medicine has certainly become likened to an easy, miracle cure – as you say, if someone doesn’t feel that they are normal, they ask for a pill to make everything better. I have been told that in other societies, this dependency is much, much less. In this sense, I agree with you that medication – although beneficial – can become a crutch.

    As Lia suggested, both deep brain stimulation and anti-depressant medication have potential complications and side effects. I believe that it’s important for the patient to recognize the benefits and risks before undergoing any treatment, as the decision is ultimately theirs.

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