Topic
'Deep brain stimulation' tested at UBC as depression cure.
Controversial treatment
Eights months ago, surgeons drilled two holes into the skull of a wide-awake Vancouver man and inserted spaghetti-sized electrical wires down through the two sides of his frontal lobes. They left behind a remote control brain pacemaker, which regularly shocks his brain with three volts of electricity, 24 hours a day, seven days a week, powered by a battery pack that sits on his neck. The device is meant to treat his severe depression. It's part of a controversial clinical trial of a procedure called deep brain stimulation (DBS) that's jointly run by UBC and VGH, and being partly funded by B.C. health care.
As part of the trial, which is co-sponsored by a Texas-based medical device manufacturer, researchers will also implant five other British Columbia patients through a multi-centre trial also happening in Toronto and Montreal. DBS is also being tested at centres all over the globe, as a treatment for obsessive-compulsive disorder, anxiety, eating disorders, addictions and even violent behaviour. But emerging data on this new technology is raising questions about the effectiveness of the procedure, the link between health care and profits, and the ethics of quick-fix psychological treatments.
With the World Health Organization warning that depression is increasingly common and is already, globally, the leading cause of disability, proponents of DBS and other neuromodulation technologies like vagus nerve stimulation are excited about the various potential promises of these so-called high-tech neuromodulation devices. Depression is now the leading cause of worker disability in Canada. And in doctors' offices, it's the fastest-growing diagnosis, causing prescriptions for anti-depressants to double between 1999 and 2004.
Final depression frontier?
Proponents of deep brain stimulation for depression say it could be a novel way to curb the illness in 20 per cent of individuals who don't respond to front-line treatments like drugs and psychotherapies. Deep brain stimulation is meant to interrupt specific pathways between the frontal lobes and the deeper emotional parts of the brain, essentially "rewiring" the brain. It's the same physiological rationale used to describe lobotomies and their modern counterparts, known as psychiatric neurosurgeries, which are said to be making a comeback at select centres round the globe, including a UBC program started in 2000. DBS is being held up as a good alternative to psychiatric neurosurgeries, because it doesn't involve permanently destroying pieces of the brain, and because the device can be turned off.
The immediate effects of DBS are often dramatic from the moment the patient is test-stimulated while on the operating table. "Suddenly my patient started laughing and talking about eating croissants and going to aerobics class," says McGill psychiatrist Dr. Guy Debonnel about the test-stimulation of his first DBS patient through the multi-centre DBS for depression trial. Debonnel notes that even a slight change in electrical placement "can change a patient's feelings in seconds from laughing to feeling bad," and they would even say they felt like crying. Debonnel says his students "were a bit scared that the technology had the power to change emotions so dramatically."
Sad blood?
The area of the brain in question is called Cg25. The role it plays in depression started in neurologist Dr. Helen Mayberg's University of Toronto lab. She hooked healthy and depressed individuals up to brain scans measuring cerebral blood flow activity, and while they read "sad" material, activity in the Cg25 area increased. Healthy peoples' brains were able to snap out of the depressed feelings quickly, but Mayberg found that depressed people "were swamped by this emotional state and found it impossible to motivate other brain areas. With depressed people there's a tug-of-war between emotion and thinking," says Mayberg.
Mayberg acknowledges that neuroscience has yet to find a clear anatomic abnormality in depressed individuals, and that brain scans can't read significant increases or decreases in blood flow, but she was able to get permission to start a proof of principle research trial with DBS. "Good news, it gave us very promising results." She said 66 per cent of the patients had significant improvement. All of them were "very disabled" before the surgery and hadn't responded to medications, electroconvulsive therapy and psychotherapy for at least five years.
"Fifteen per cent of these individuals will commit suicide without treatment," says Mayberg, "but after DBS, many are back at work."
Post-operative psychological tests of the Toronto patients showed no negative cognitive and behavioral effects, though various studies elsewhere have linked the types of blood flow changes seen in DBS patients to mania, dementia, lack of response to aversive scenes and serious psychiatric personality disorders like depersonalization and psychosis. Long-term follow-up will be necessary to see whether physiological damage to the brain and the central nervous system occurs as well. The Toronto group has yet to publish data on post-operative neuropsychological tests, but their initial paper contends that none of the patients had cognitive impairments or adverse behaviour changes.
Light bulbs
In Toronto, after researchers published the results of their first study, over 300 people with chronic depression wanted to sign up for DBS. A few patients spoke to the media after their operations, and credited the benefits of the procedure. One Toronto patient described it as if a light bulb had been turned on. She said that upon returning home from the hospital, she threw on a hat to cover the surgical staples, and went straight out into the garden to clip the hedges. Others said they were finally able to get out of bed and start living their lives, returning to work and school.
Reports from other centres doing DBS for obsessive-compulsive disorder showed similar success rates. Though they reported two downsides: the battery packs had to be surgically replaced within five to twelve months due to the high voltage rate. And the treatment failed altogether for two of the patients, who went on to receive irreversible psychiatric neurosurgeries.
There have been other questions raised by the results of the surgeries. One European patient treated for social anxiety was so enthralled by her improved mood that she asked her psychiatrist to turn up her voltage for a weekend social event, hinting at the potential off-label use of this type of technology to tweak performance in high-functioning individuals like athletes and brain workers, or even inhibit violent behaviour in criminals.
'Unperfected'
The UBC team acknowledges the various ethical issues and says strict guidelines and protocols are in place. "We're flying into pretty complicated territory here. The process is unperfected," says Dr. Andrew Howard, a UBC psychiatrist who is responsible for meeting with the DBS trial patients weekly to fine-tune their electrical implants with the remote-control computer devices stored at his office. "This could be a new dawn for psychiatric neurosurgery, but considering the horrible history, we can't repeat those mistakes."
"We don't know how the technology works, whether it's stimulating or inhibiting the brain," says Dr. Chris Honey, the VGH neurosurgeon doing the local surgeries. "We're in the honeymoon stage right now, but that might end," he adds, particularly since the mechanisms of deep brain stimulation, and the workings of the Cg25 target are little-known, though clinical studies have linked it to moral decision-making, and tissue damage in the area has been associated with disinhibition, which is associated with frontal lobe brain damage causing negative behaviours and poor impulse control.
Bio-ethicists and psychologists are also concerned about the procedure, due to the corporate moneymaking potential. The neuromodulation market is already said by one firm to be worth about $3 billion US and is forecasted to reach about $8 billion by 2010.
Dangerous cures
Recent studies on DBS show that this technology also comes with many adverse side effects. In Canada, DBS has been used to treat Parkinson's disease since 1997. And clinical studies from these treatments have chronicled various dangers, including stroke and death from the surgery along with post-op cognitive deficits, suicidal tendencies and negative personality changes ranging from mania to depersonalization to criminal activity.
"Brain surgery for mental disorders should have gone out with stone age trepanation (boring holes in the head)," says Dr. Alan Baumeister, chair of Biological Psychology at Louisiana State University.
Dr. Baumeister has done extensive research on the checkered history of neurostimulation, then known as Electrical Brain Stimulation (EBS). Baumeister is concerned about the recent chatter amongst psychiatrists, neurologists and neurosurgeons that psychiatric neurosurgeries are ready for a comeback as a last-resort treatment for mental disorders. He says the same thing happened when the frontal lobotomy was introduced in the 1930s, before the treatment was restricted in the 1970s (after over 50,000 lobotomies were performed in the U.S. alone). "So, to say the least," adds Baumeister, "I am dubious about DBS."
Dr. David Roy, founder of Montreal-based Centre for Bioethics agrees. "Horrific, ethically unacceptable experiments happened in the past around psychiatric neurosurgeries and brain stimulation, supported by major medical journals and governments." He says once again, there's a high enthusiasm for DBS as a treatment for mental disorders without evidence of significant benefits, and warns that the enthusiasm could "lead us into a new wave of abuse."
Talk, drug or cut?
Francoise Baylis, a Dalhousie-based neuroethicist has another concern: the funding of the UBC study. The surgery itself is being covered by government health care funds. She says that typically, the health care system doesn't pay for clinical trial research, and that drugs, devices and procedures need to be thoroughly clinically tested before taxpayer dollars are spent funding them. "We need a healthy dose of skepticism about these neurotechnologies and approval policies. Everyone is vulnerable: the institutions looking for access to grant money, and the patients."
Dr. Mayberg, who now works at Emory University in Atlanta, acknowledges that, "In the U.S. we have a lot of hurdles [with DBS trials] that you don't have in Canada. We couldn't do here what we did in Toronto, since, in the U.S., the expectation around research trials is that the manufacturer will pay for everything."
Dr. Wolfgang Linden has a different set of concerns about the implications of using surgery rather than cognitive approaches like talk therapy. "Many depressed individuals grew up in dysfunctional families or have had really negative experiences in their lives," says Dr. Linden, a UBC psychology and president of the BC Psychology Association. He says treatments like these take a black and white approach to treating mental illness and ignore core psychological issues. He adds that the government under-funds psychology, and that only about five per cent of the B.C. population has access to psychotherapies, mostly through private insurance. "If you work for McDonald's, forget about it."
Prescribing sanity
Linden points out that many clinical studies have shown that people who receive cognitive behaviour therapy are more likely to curb depression long-term than people who take medication, but they're "under-treated with these time-tested treatments" and end up at their GP's office looking for help which too often comes in the form of a drug prescription.
Dr. Lam stresses that "the patients undergoing DBS have already failed cognitive therapy and other psychological treatments in addition to biological treatments," and he contends that, "It is never a simple question of either/or." He cites the analogy of "heroic and invasive" treatments for people with severe cardiovascular diseases, "even though we know that funding exercise programs and dietary programs can prevent many of those diseases."
The UBC team initially told The Tyee that their first patient had yet to "respond" to the DBS treatment. His condition is currently unknown, as UBC is not releasing information to the media and will not report whether any other patients have since received the implant. Dr. Howard has said that whether the first patient responds or not, they plan to proceed with DBS for another five patients.
"Only in dramatic cases do we hear about things going wrong in clinical trials," says Michael McDonald, founding director and chair of UBC's W. Maurice Young Centre for Applied Ethics. "We shouldn't impede research but we should make sure to protect citizens. I can tell you exactly how many animals were researched and exactly what happened to them, but we have no national database for human medical trials. That sure says something about our culture."
Related Tyee stories:
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Mr. Beer N. Hockey
6 years ago
Comments on "The New Lobotomy?"
Ken Kesey is rolling over in his grave.
Alcibiades
6 years ago
Why does this story bring to mind Dr Ewan Cameron and the Allen Memorial?
Wasn't it the CIA paying the bills in that case?
And, why do you suppose depression is so widespread and growing so quickly?
gaulois
6 years ago
The "quick" tech fix is always appealing, never mind the real consequences of not dealing with real root causes. After "soma", why not brain plug-in gismoes then? I wonder if they could develop one for our politicians and bureaucrats. But then that would cut the larger market. Just a thought.
Nana
6 years ago
Many of the causes of depression are biochemical, for instance post partum depression is caused by lack of the essential fatty acids. Instead of prescribing them or even examining the new mother's diet she's subjected to pharmaceutical assalt. There would be far fewer tragedies like mothers killing their children if their physicians paid attention to both nutrition and individual biochemical needs.
400 mgs daily of Vit B3 in the form of niacinamide was enough to get me out of lifetime depression. I could go 3 days without the B3 before I went down again, but it only took 15 minutes after ingesting the tablets for the sun to shine again. Stangely, after age 42 it had the opposite effect.
Megavitamins helped me function well under fairly stressful life conditions.
It was a solution I found myself and was often condemned for by physicians who refused to examine the literature and who equated megavitamin therapy with "drug addiction".
maestro
6 years ago
The drug industry etc. is the "new" opiate of the masses ......and more faith - based than the old alleged opiate .
Danielle E
6 years ago
Alcibiades, you are right, the early EBS experiments were largely funded by the CIA and the military. Remember Jose Delgado's experiments with the bull? He also tests mental hospital patients Check out: http://www.wireheading.com/jose-delgado.html.
They also have some pages on Robert Heath doing these experiments in Tulane. Another good source for historical info is at http://www.skewsme.com/implants.html
Other than the ethical implications, one of the reasons these experiments were halted was that behaviour changes were often unpredictable and undesirable. Other patients at Tulane chose to jump out of their hospital windows.
Alcibiades
6 years ago
Yes I do Danielle.
Thanks for helping me point out some of the more 'interesting' coincidences that lie in the shadows behind your story. I think the funding almost always tells a story behind the story. Martha Piper should be very proud that she's brought a ‘tradition’ that previously was more common at McGill, Queens and U of T to UBC. Research funding is almost never disinterested is it? Shouldn’t use the passive voice, but, it seems so appropriate to most Canadians’ behavior these days.
And rightly so, few of its alumni remember that UBC started its life as a branch plant of the Montreal institution. Tuum est, as they say, or always used to - out at Point Grey.
Nana
6 years ago
The first head of the World Psychiatric Association at its founding in 1961 was none other than Ewen Cameron, which should give one pause.
I forgot to include the link for the International Society for Orthomolecular Medicine. The article by Linus Pauling is well worth a read.
http://www.orthomed.org/
cocean
6 years ago
This pretty much says it all. Follow the money.
Why on earth would Big Pharma, the knowledge industry, government, and all the other 'stakeholders', want to address the CAUSES of increased depression - such as growing poverty, violence and workplace stress? That would be too ethical, too responsible, too caring of the population by far!
haraldkann
6 years ago
No kidding !
Look around at the state of the World...over there and right under your feet.Small wonder more of us are not SUICIDAL,those of us with a conscience will always fight the BLACK DOG in the dark night.
Those without conscience will always thrive in a sick world.Pyschopaths will always rule and they guide the BLACK DOGS,THE DOGS OF WAR and THE HELL HOUNDS...
Kurt Vonnegut said it best...WELCOME TO THE MONKEYHOUSE .
Danielle E
6 years ago
There's still a psychosurgery program at Cameron's Montreal Neurological. And long before his psychic driving and LSD experiments, Egas Moniz gets the Nobel prize for lobotomies. Walter Freeman taught his surgery-free (ie you don't have to be a neurosurgeon to get in there)icepick lobotomy technique to psychiatrists all over N. America, includuing Riverview.
Anybody interested in alternatives should check out Peter Breggin's work at breggin.com
Alcibiades
6 years ago
I liked your article Danielle, and what you’ve posted since - that turn of phrase especially - 'the Nobel prize for lobotomies'.
My mother, rest her soul, spent half her life tortured by ECT, nearly died from Lithium poisoning and ended up a frightened ghost waiting to die in a darkened room.
The desperation of depression sufferers leads them to try almost anything...torture included.
snert
6 years ago
cocean
These are causes off clinical depression?
Alcibiades
6 years ago
They are contributing factors.
snert
6 years ago
When others can handle a job without getting depressed how does that job become a contributing factor to clinical depression?
Alcibiades
6 years ago
I'm not here to educate you snert. Read a bit more, live a little, you'll figure it out.
Nana
6 years ago
snert When the studies on vitamin deficiency states were conducted in the forties, one of the things found was that there could could be a 50X difference between littermates in the amount of a nutient needed before a difficiency state would manifest itself.
This helps to explain why only one sibling will be subject to depression and the others are just fine.
One of the researchers, Dr. Roger Williams, said that one must take into account that the rats had been laboratory bred to be as uniform as possible and one must also realize that with the diversity of most human populations the difference between individual needs for nutients is bound to be even bigger.
Nana
6 years ago
I forgot to add, stress increases the need for certain nutrients, like Vit C and Vit B5.
The researchers said the laboratory dogs which were being deprived of B5 looked fine until they suddenly died. The decision was made not to continue to the next step which depriving human volunteers of the vitamin.
True, in a rational society we would not be placed under the stresses we are being subjected to, but the kind of depression
that this article refers to is different than that caused by stress.
Health Canada tried to keep a vitamin preparation out of the hands of the public. The company sued and won, but there were suicides among those whose supply was interrupted.
http://www.truehope.com/
The powers that be would rather have thecyborg solution
Nana
6 years ago
http://www.truehope.com/_success_stories/success.asp
jtothemfk
6 years ago
,cites cocean, and comments:
well put! it is truly the most awful type of con, too. The measure itself -work days lost- says a lot. And for every side-effect/fallout of our modern world (i.e. people not being able to get out of bed for lack of hope) there is always somebody with a wink, a promise and a success story to sell.
others have commented about the lack of insight into causes. I agree %100.
I appreciate the work scientists do. I believe most scientists are fascinated by their subject and only want to "solve the problem". I guess one major draw back is the near-sightedness. The intelligence is aimed at the wrong target. The problem is not depression but what causes depresssion.
Our government and business recognize depression as a problem in terms of $ lost due to. So the solution is to find a way to make Joe and Jane Worker not depressed so that they can be worthy of their surname. Cognitive therapy is terribly expensive and painstaking and only the wealthy can really afford (time and money-wise) to follow that process through. Drug therapy can get many of these depressed liabilities back in black. Cheaper. But if this one time EBS shit checks out... voila!!
So rates of depression continue to increase and little attention is paid, little time is spent in studying and understanding the human interaction with its surroundings. If EBS works, then let's all just get 'er done, eh? No more man-hours lost to our own righteous loathing of an impersonal, cold and calculating world of ledgers.
jk
jtothemfk
6 years ago
snert,
as to your question why one person gets depressed doing the same job that another person is more or less content with:
first, all people are different and react to experiences differently;
second, many people are self-reflective and ask themselves questions about purpose
third, and most importantly, I don't think people get depressed at jobs or because of jobs, per se.
there are many aspects to a life. a job is one. the why and how are bigger and more frightening questions. If you never ask why or how, you'll be alright, iguess.
jtothemfk
6 years ago
one last comment before i turn in, and this just a theory based on sincere thought but only casual observation and absolutely no data that i'm aware of, so bear with me..
Depression is most prevalent amongst cultures which are more or less stagnant and those which have very thoroughly been degraded by an oppressive/dominant culture. Generally, individuals in such cultures are often left thinking "this is it" or as Nicholson put it "this is as good as it gets". Whenever there is something clear in the "road ahead", when there is something seen as worth struggling for, there is no depression because the movement and struggle forward occupies the thoughts and emotions.
If we take Canada as an example, I'd bet that the prevalence of depression is greatest in 3rd + generation europeans and first nations peoples. I don't know if i'm right but i'm going on my theory. I'd bet that depression rates are greater in the U.S., Canada, Britain, France, GErmany, etc.. as well as Urban and sub-saharan Africa (though assessments in those latter areas are probably skimpy.
Just a theory.
diurnal
6 years ago
If this research was for cancer,parkinsons,alzheimers,diabetes,or tourettes there would be no discussion about it. Meaning everyone would accept it, but the stigma of mental illnesses will never go away. One day mental illnesses will be treated as the above diseases. Sadly, it want be in my life-time.
snert
6 years ago
jtothemfk
That was going to be my point eventually. I think the three factors that were listed all fall into the same category of not being factors in 'clinical depression' which is what DBS is being tried on.
Nana covers it off quite nicely.
snert
6 years ago
not being factors should read; not being contributing factors.
maestro
6 years ago
Alci and G West:
Interesting psychoANALysis /profiling of a few of the more popular TYEE bloggers going on by DR. N-TG (one and the same )at the tail end of the " Terry " article...
check it out.
Danielle E
6 years ago
diurnal: questions about various technologies, drugs and treatments are indeed under question with all of the diseases you mention above. tourette's and epilepsy patients have been treated with all sorts of neurosurgeries over the past 50 years (including removal of entire temporal lobes) and before that, at least some of these individuals were looked up in the asylums. With this DBS topic and psychosurgeries specifically, they can cause epilepsy in people with no past history of the disorder. And looking at adverse effects of Parkinson's DBS patients is a jumping off point for all of the research on the use of this tech with mental illnesses. cancer also a contentious area of research. the main difference would be that with the organic diseases, they can find a tumour or an abnormal cell; with Parkinson's they can find the specific piece of the brain where the tics occur. with mental illnesses they can't do this. they can find bio-chemical markers, but as Dr. Linden pointed out, nobody has a clue whether these biological changes are the root causes or the symptoms of psychological issues. that is an important caveat as biological psychiatry dominates the field.
Alcibiades, really sorry to hear about your mom and ECT. I've heard from others that it can have a very strong, sometimes devestating effect on future generations. There's the legacy of genes but life experiences are of course incredibly powerful. Have you heard of ALbertan Wendy Funk? She wrote an amazing book about her life after ECT called What Difference Does it Make?: http://www.ect.org/news/wendyfunk.html
That site in general is an excellent place to read about the continued use of ECT.
Alcibiades
6 years ago
Danielle
Thanks so much for your kind words. My mother died a year ago this summer so I've pretty much tried to put it away since then. Funk sounds as if she's done well - I hope it continues. Lots more I could say, but this isn't the place. Thanks again.
Bailey
6 years ago
I want to come in on the side of the snert here, albeit at a bit of a tangent. I believe, and have maintained for years that sadness, despair and grief are NOT depression, clinical or otherwise. The confusion arises from the fact that serotonin cycle stimulation by drugs, ECT, even hypnosis, can easily mask those normal human feelings and make it impossible for a human to feel them.
Very convenient for a therapist who is himself unable to feel them. Such a therapist might easily conclude that such feelings are abnormal.
I think that a proper definition of depression must point out that the feelings which are symptomatic must be caused by the imbalance of neurotransmitters, not be the cause of it.
When snert points out that unhappiness at work is not clinical anything, much less depression I think he is quite right. Furthermore, I must question if going back to work is a valid benchmark for anything except unwillingness to starve in a dumpster with the others who share your feelings.
In the light of studies which are giving strong indications that our work culture has become somewhat overinfluenced by psychotic thinking patterns, it would be as easy to argue that the problem lies in the increasing dehumanization of our work and social ethics. Real humans with real human qualities find it harder and harder to tolerate life without say, loyalty. Or compassion.
When a real person goes to work at a Government office for example, and is ordered to turf the sick and the fragile out of their hard built supports and homes, and into God knows what, and that action results in deaths of clients, what emotions should he feel?
Then add his realization that his masters don't understand or care about these considerations and his feeling is multiplied.
I say widespread sadness and despair among healthy humans is a proper and appropriate response to a massive increase of inhumanity among the philosophical and economic underpinnings of society.
What they're seeing the huge increase in; what they're really treating isn't depression, it's outrage.
Alcibiades
6 years ago
Bailey,
No quibbles on what you say. I think inappropriate treatment and sloppy diagnosis (DSM -IV) protocols are clearly part of the problem as well.
Interestingly, the culture would rather treat with the pharmacopoeia its problems than undertake the fundamental structural analysis necessary to address the issues you point out so clearly.
Danielle E
6 years ago
Yeah Bailey, an emerging theory that fits in with your outrage post is that particularly with bipolar depression, a core issue is elevated anxiety levels which cause a whole host of biochemical, hormonal, CNS, para and sympathetic nervous system responses.
nana mentioned stress response issues and vitamin therapies and a decent naturopath would recommend a range of natural hormones, amino acids, vitamins, gaba etc to try and get the brain calmed down. there are quacks everywhere of course so I realize it's buyer beware wherever you go, whether talk therapist shrink or alt health pract.
and how do polite CDNs vent their outrage? (other than tyee posts!)
steerpike
6 years ago
This is code for "murderous rampages"
Cyclist
6 years ago
To Nana:
you say you used vitamine B3 but the links you provide to truehope.com are to a site selling a product called EM Plus, so I'm not sure what the connection is and whether this is a product you used in addition to vit B3. Thanks.
xbie
6 years ago
Terrific article, Danielle, thank you. All of your writings on mental health issues that I've seen have been refreshingly sober (compared to the way most journalists swallow the pseudo-scientific propaganda hook line and sinker) and informative.
It's bizarre how times change and people come to accept, and then no longer accept these things. As you pointed out, about the Nobel for lobotomies (also for the inventor of DDT!). I still see quotes from people saying things like "it belongs in the dark ages, resigned to history with lobotomies and electroshock", i.e. utterly unaware these things are still very much features of modern mental health treatments. With all the misleading claims about "genetic" roots for mental illnesses, I often wonder how far we are from the return of eugenics and forced sterizilations.
Did you follow the "digital angel" arc? This company came out with one of the earliest commercial implantable chips, and got such a huge negative backlash with people comparing it to Nazi tattoos and the 666 of the beast, etc that they basically shelved it. It's now years later, they're turning profits hand over fist, and it's hard to find a protester even for these brain-manipulation chips.
Why do you think our culture has become so addicted to professional psychiatric and psychological interventions?
Danielle E
6 years ago
Thanks Xbie. Yeah, digital angel has just received an fda patent for a diabetes implant. Lots of ethical issues there, like availability of your vitals to hackers, potential future adaptations for addicts or criminals, what are the physiological risks being hooked up to a satellite 24/7?
As for your last question, after researching this topic for a few years now, I’m even more clueless. The list just keeps getting longer and of course they’re all intertwined with broader cultural, economic and political issues. Why are people in “developing†countries like Nigeria ranked as “happier†than North Americans? Do we view happiness/contentment as a luxury good, a necessity? I assume that each individual has their own unique and complex reason (even if, ironically, it means taking a pill so that you can fit some mythical picture of “normal†fit in) but considering the fact that in Canada over 22 million antidepressant scripts were written in 2004, I have to wonder about quick fixes. (I hear psychotherapy involves a lot of homework!)
Your thoughts?
Nana
6 years ago
Cyclist
I was talking about the combination of B3 and Vit C for schizophenia which was proven by Dr. Abram Hofer and pointing to Empower(Truehope) which has been used with great sucess with suicidal depression and bi-polar disorder. The University of Alberta did most of the studies proving its efficacy. Re examine truehope.com and read this and the links provided.
http://www.iahf.com/orthomolecular/orthomolecular.html
Nana
6 years ago
I forgot,your question was about my personal experience. It was reading Adele Davis in the 70's that led me to try niacinamide for depression. When I added megadoses of Vit C 3-4 x a day, my feelings of rage. which were triggered by allergy to cats, housedust and horses, disappeared. Linus Pauling's book Vit. C and the Common Cold had just come out and with 4 kids bringing things home from school we were always coming down with something. Having more self control was an unintended consequence.
Cyclist
6 years ago
To Nana:
Thanks for the info.
peefer
6 years ago
The wealth of the average north american has tripled since the 1950s. Any studies of happiness show no such increase. In fact, the opposite.
Hmmmm.
xbie
6 years ago
Thanks for your reply, Danielle. I'm glad to see the writer so actively participating in the dialogue. As for your direct-back of my question, I could go on and on. But a couple key things: It seems the world is moving ever deeper into crisis, so people are becoming ever more psychologically upset, and then we seem to be choosing to head more towards "adaptively conforming" instead of towards "breaking through". I've been somewhat influenced in my thinking by Tana Dineen's http://tanadineen.com/
way of seeing both psychiatry and psychology as similar types of misguided approaches, and as overall purely a big-money pop-culture phenomenon exploiting people's very understandable growing angst. And also by the breakthru work of psychiatrist Dr. Stan Grof http://www.holotropic.com/about.shtml
Are you familiar with Grof? I really think more people who question biopsychiatry and mental health assumptions should be aware of his more radical model of the psyche and collective 'spiritual emergency'. It can seem flakey, until one actually tries breathwork or psychedelics...
Interestingly, other people on this forum are talking about Hoffer and his nutritional approaches -- and of course Hoffer's early work, too, was in psychedelics. Indeed, his whole vitamin B3 approach is based on an assumption that "schizophrenia" is induced by a naturally-occurring but exceedingly unpleasant hallucinogen, adrenochrome.
depress
6 years ago
To Danielle E, Alcibiadesand others,
The tittle of that article is very upsetting considering this operation is not a lobotomy. It is totaaly reversible and nothing is taken away from your brain. In Dr Cameron case he did not inform his patient about the research they where on In this kind of research there is an Ethic committe with 2 members of the community that has to approve it before it even starts. The 2 community members have the power to not refuse it. Then when there are incidents during the research, the committe is inform about them, related or not, and can stop it. The patient can ask as many question has he wants before signing the inform consent form. He may later on change his mind and stop to participate.
Danielle you also had the possibility to talk to one of those patient. You chose not to do so , it is to bad because you would have receive a lot more imformationa and may be found a more appropriate tittle.
You can have a lot of conscience courage, determination and even do Cognitive therapy and still need that kind of operation It save me because Depression is not only cause by the environment but also by your genetic backgroud. Thank to that operation I am discovering what it is not to be depress and what is life. And a lot more of us are glad we were given that new choice
diurnal
6 years ago
The New Lobotomy?
The author already answered what a lobotomy is "DBS is being held up as a good alternative to psychiatric neurosurgeries, because it doesn't involve permanently destroying pieces of the brain, and because the device can be turned off." So why lead the article with this when its already answered? Then the author says "'Deep brain stimulation' tested at UBC as depression cure". Who ever said it was a cure?
Mayberg, of course its absent, said, "if people think DBS is cureall, they are wrong and we are sorry if we came across as saying that." Why infer thats its a cure when no one said it was, at least the creators of DBS?
Moreover, the critics are numerous in this article. For example, I've read Dr. Baumeister history at Tulane' EBS. To say the least it was atrocious. And for him to comment on DBS is definately going to get a negative comment. If I saw what they did at Tulane I would say the same thing. Having that said, that's about the most bias doctor that the author could conjure up. The procedures in DBS today have been refined, has Dr. Baumeister even read the Mayberg study?
Finally, as the author has posted back it seems there is some sort of "mad scientist" feel to her answers. Links to CIA sites, ethusiasm to gladly post them, and secret conspiracy cover-ups. The author, in my opinion, is outside looking in about DBS and mental illness.
Remember mental illness ruins people's life(not DBS) and if there is a chance to get better,with ethics involved,(which clearly DBS is monitored) then it should be given a chance. In fact, with overtones of CIA, mad scientists, and old studies this article really can not be taken seriously. On the contrary, the author had some good information, albeit extremely partial.
Danielle E
6 years ago
To Depress: I am blown away to hear this information. For over six months, I tried very hard to speak with someone who’d had a DBS surgery. I talked to the Vancouver group and they asked their first patient if he’d speak with me. He declined to do an interview. I asked the Toronto group, through their PR person. They declined. I asked the Montreal group and they didn’t get back to me. You were misinformed if you were told that I declined to speak with a patient. You can get my contact info from the researchers and I will do my best to publish an article that focuses on your experiences.
I agree with you that it’s of the utmost importance to have ethical boards involved and ideally a neuroethicist. Some of the psychosurgery doctors I spoke with talked about their fears around these procedures being done outside specialty centres. (Of course, in Canada, medical coding should make it easy to track the number of procedures, though, unfortunately it’s not.) You mention informed consent issues, but it is difficult for the general public to understand these issues when we’re not able to talk to a patient and further, aren’t given access to information on informed consent. I asked to see the informed consent documents, so I would fully understand the process, but I was told that the researchers and the ethics board had signed a confidentiality agreement with the manufacturer and thus couldn’t supply me with this information. I am glad to hear that you’ve benefited from the procedure, but I’m sure you agree that it is crucial to go in knowing as much as possible. Are you saying that the rest of us should only know so much? As I point out in the article, many people wanted to have this surgery.
Danielle E
6 years ago
To Diurnal: In a variety of media articles, DBS has been held up as a new technology. Though some of the technological aspects – computer chip, etc - are relatively new, the rationale for this type of surgery remains the same as it was back in the 40s: to change behaviour. (The goal of various treatments, from drugs to talk therapy are to change behaviour, this one just happens to involve electrical brain stimulation.) It is my job to talk about a treatment’s history, particularly when that history stirred up so much controversy.
Isn’t a goal of this program and the application of the technology itself, as Dr. Howard pointed out, to try and ensure the same mistakes aren’t repeated? Are you saying that there shouldn’t be balanced feedback between the doctors involved in this treatment (who I believe were forthright about the pros, cons and potential issues down the line, Mayberg especially) and other doctors and bioethicists? Dr. Lam makes a very compelling point near the end of the article and I completely agree that depression is a very serious disabling condition. It is one of the reasons why I take the job of due diligence in researching so seriously. Naturally a look at the history would lead me to Dr. Baumeister’s studies, among many others. To say that he has been “conjured up†is incredibly disrespectful to the research he has done and also the patients that suffered or died because of this technology. There are no easy answers here as many forum participants point out. It’s strange that you would belittle a writer for continuing to discuss and underline the multiple nuances of mental illnesses. Your repeated posts indicate to me that you don’t think it’s important that citizens should have a full picture on any clinical trial or medical procedure. Just shut up and follow the doctor’s orders? For a journalist, just read the corporations’ press releases? That’s incredibly old-fashioned and these days, the many good doctors I know think it’s critical for the patient to do their own research and for the media to help them do that.
Thanks Xbie and Nana for info and links. Re. clinical therapeutics with Hoffer and Osmond, it’s interesting that their research contributed quite a bit to the eventual pharmacorp development of chemical modifiers - called chemical lobotomies by critics - and the bio-psych model. Even earlier, Freud was using cocaine, opiates and surgeries as well.
Danielle E
6 years ago
Depress: one more issue from your post saying DBS is "totally reversible." DBS is IDEALLY reversible, but the Vancouver doctors said that if a patient doesn't respond to DBS, they will not recommend that the device itself be removed since removal surgery could cause damage to the brain. Also, they don't know about the long-term implications when the brain naturally grows around the implant. Were you told about that?
Another important issue is what are the effects of combined DBS and pharmaceutical drugs? Many patients in the study I read about had to continue taking their anti-depressants. (And many of the Parkinson's DBS patients also continue taking drugs.) Again, the researchers don't know about the effects since pharma-trials on these drugs didn't involve patients who were also electrically stimulated.