Electricity has been considered a method of healing the mind for more than 2,000 years - long before scientists even knew what electricity was. In ancient times, electric eels were used to suppress headaches. Now recent advances in brain stimulation techniques using a variety of waves, electricity, and magnets have brought progress in treating mental illness and such conditions as addiction, memory disorders, anxiety, depression, and obsessive-compulsive disorder—all of which can be resistant to more traditional treatments.
There’s growing consensus that mental illness stems from complications in the brain’s electrical circuits so altering electrical circuits while balancing brain chemicals is the best approach to treatment. In the past, Sigmund Freud fostered the belief that most neurological disorders were caused by mothers; later the prevailing wisdom was that an unbalanced brain chemistry was to blame. There is still much about brain circuitry that psychiatrists don’t fully understand, but the latest research has shifted its focus in that direction.
What current treatments exist?
As psychiatrists have learned more about which regions of the brain are affected by mental illness, how they are wired, and which regions are associated with specific disorders, a host of brain stimulation therapies have been developed.
Electroconvulsive therapy (electroshock therapy)
Electroconvulsive therapy (ECT) is the oldest of these practices, during which an electric current is triggered to induce a brief brain seizure. Despite having come under much scrutiny by the FDA for potential side effects, and negative portrayals in popular culture, such as the movie “One Flew Over the Cuckoo’s Nest,” current methods are much safer, use anesthesia, and cause fewer side effects.
ECT remains one of the fastest and most effective treatments for major depression. Without it, psychiatrists predict that suicide rates would increase significantly. More than 100,000 ECT procedures are conducted each year in the U.S.
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Magnetic Seizure Therapy (MST)
Because the use of ECT is limited due to memory-related side-effects, as well as the stigma associated with it, patients may prefer this newly developed therapy. MST induces a seizure through the use of magnetic stimulation, rather than a direct electrical current like ECT. The use of magnetic fields allows for a more precise focus of stimulation than the use of electrical currents.
MST has been found to alleviate symptoms of depression without the loss of memory some experience with ECT. MST is still relatively new and scientists need to continue to compare MST to ECT methods across a range of treatment indications to gauge its effectiveness and safety.
Transcranial magnetic brain stimulation (TMS)
Recently, new research revealed that transcranial magnetic brain stimulation (TMS) has the potential to reduce symptoms of depression without the sleep side effects associated with anti-depressant medications. This has great potential for the 14.8 million American adults suffering from treatment-resistant depression and those who experience sleep side effects from anti-depressants--which can make depression worse.
The majority of patients with a major depressive disorder suffer from antidepressant-exacerbated insomnia. TMS works by stimulating the frontal lobe of the brain with a magnetic current. The magnet increases the activity of brain cells on the surface of the brain in the region associated with decision-making, evaluating, planning, and other higher-order functions. TMS is a less intrusive treatment option since a patient doesn’t need to go under anesthesia and is treated while sitting in a reclining chair with brief MRI strength magnetic pulses applied to the front of the head.
Transcranial Pulsed Ultrasound (TPU)
The use of pulsed ultrasounds to the brain is also showing promise in treating neurological disorders. Scientists have known for decades that ultrasound can influence nerve activity, but until recently invasive surgery was required to implant electrodes into neural tissue prior to stimulation. Now, scientists are experimenting with direct ultrasound stimulation to stimulate brain activity without any sort of surgery.
Cranial Electrotherapy Stimulation (CES)
This is an older technology which has gained new attention for treating sleep disorders, anxiety and depression. CES sends a microcurrent into the brain (like ECT, but much weaker and less invasive) and now is even possible through the use of small battery-powered devices at home.
What about surgical options?
There also are two brain-stimulation techniques that require surgery. Both techniques are effective, however they do pose some risks, including infection and stroke.
Vagus Nerve Stimulation (VNS)
VNS is a small device that is implanted near the base of the neck to deliver continuous electrical pulses to the vagus nerve--a nerve responsible for telling the brain what’s going on in the rest of the body. VNS received FDA approval in 2005 to treat epilepsy and treatment-resistant depression.
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Deep Brain Stimulation (DBS)
In DBS, electrodes implanted in the brain are linked by wires to pulsing devices in the chest. The electrodes emit signals to brain circuits believed to be responsible for depression. While its effectiveness for treating depression is still unknown, this treatment has been effective in treating patients with Parkinson’s disease.
What does all of this mean for future treatments?
Each method has been effective in treating a variety of conditions, and as more research is conducted, scientists get a better grasp of what is happening in the brain with a range of neurological conditions. Treatment will likely become less invasive and more convenient with the use of battery-operated and handheld devices. While such therapies are often used in combination with medications, the push in the psychiatric community is to move away from medicating and towards therapeutic options that have fewer potential side-effects.
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