Scientists reveal new treatment for depression symptoms
Australian Broadcasting Corporation | Broadcast: 23/07/2015 | Reporter: Jason Om
Copyright © 2015 ABC All Rights Reserved
A treatment called transcranial magnetic stimulation, or magnetic waves, has been developed to help treat people with depression and depressive symptoms.
EMMA ALBERICI, PRESENTER: It’s a frightening statistic, but on average, one in seven people will suffer a major depressive episode in their lifetime. There are drugs, but it’s also true one in three people don’t respond to those drugs. For those people with severe depression who don’t respond, ECT, or electroshock therapy, can be used, but it can have terrible side effects. Now there may be an alternative that is less intrusive. That includes a treatment called transcranial magnetic stimulation; in other words, using magnetic waves to probe the brain. Jason Om met one woman who’s found this technique has changed her life.
SUSAN PEAK: To me, it would be the equivalent of going through torture at somewhere like Guantanamo Bay.
JASON OM, REPORTER: A pall of depression has plagued Susan Peak for many years. The freelance journalist first experienced it in her mid-30s.
SUSAN PEAK: For me, there are different sorts of depression. But for me, I suffer from the melancholia style, which is a lot of crying, non-stop crying and just this very deep, dark hole that you’re in and you can’t get out of. But worse than that, really, it’s like somebody else is controlling you. There’s a puppet – you’re puppet and there’s a puppet master sort of holding the strings and they decide when they’re gonna have a jab at your nervous system.
JASON OM: Susan Peak tried medication, but it didn’t work for her and she needed a different option.
SUSAN PEAK: I decided to go off my tablets at the end of 2012, which wasn’t a good idea, and I sort of went downhill. I’ve got what’s called treatment-resistant severe depression. So, yes, the medications did not always work.
JASON OM: These days, Susan Peak is more in control, thanks to a more recent technology known as transcranial magnetic stimulation, or TMS.
During the treatment, magnetic pulses are delivered through the scalp.
So Susan, how are you feeling?
SUSAN PEAK: Great.
JASON OM: And what’s actually happening to your head?
SUSAN PEAK: Ah, some invisible healers are working on my neurotransmitters. It’s not really anything you can see or touch or hear other than the click, click, click of the device working.
JASON OM: This scan shows what happens to the brain during TMS as different regions are activated.
PAUL FITZGERALD, MONASH ALFRED PSYCHIATRY RESEARCH CENTRE: We apply it in a way where we give lots of these pulses each day and over multiple days. And when we make nerve cells fire repeatedly, we tend to make them more or less active. We can kind of tune the brain up or tune it down depending on what type of condition we’re trying to treat. So in the context of depression in particular, we know that there’s an area of the brain that appears to be underactive in people with depression and so we use TMS to increase the activity of that area of the brain.
JASON OM: This treatment is an alternative to the commonly-used electro convulsive therapy which stimulates the brain with electric currents to induce a seizure.
PAUL FITZGERALD: Having TMS is somewhat simpler than ECT. It doesn’t involve having an anaesthetic like ECT does. Patients can come in, have their treatment, literally walk out the door and go back to their lives pretty much instantaneously. TMS also seems to be better tolerated. We really don’t have any serious side effects with TMS. It doesn’t affect our memory or thinking in any way.
JASON OM: Before you’re going into that room, how are you feeling and then how do you feel when you walk out of that room?
SUSAN PEAK: Ah, it’d be nice to say that you go in feeling droopy and gloomy and come out skipping, but no. It just – it’s sort of no different. You can’t really feel changes happening as you’re having the treatment, or I didn’t. It’s very subtle. Maybe two weeks afterwards, I felt quite different. Much lighter, much less – no melancholy, no crying, no gloomy times at all. It just boosted my mood quite dramatically, really. As I say, it’s the best I’ve felt in 21 years of having the illness.
JASON OM: Have you had any side effects?
SUSAN PEAK: No.
JASON OM: At Melbourne’s Monash Alfred Psychiatry Research Centre, researchers have used TMS on more than 1,100 patients over 10 years.
PAUL FITZGERALD: What we found in that group of patients is about 45 per cent of our patients getting a really substantial, meaningful clinical response. Perhaps another 20 per cent or so of patients getting some benefit without it necessarily being life-changing. And I suppose about a third, slightly over a third of the patients not doing much for at all.
JASON OM: The researchers are also looking at other treatments such as direct current stimulation. This treatment uses electric currents and is designed for people with brain injuries or schizophrenia.
KATE HOY, MONASH ALFRED PSYCHIATRY RESEARCH CENTRE: We think that it has considerable potential for improving cognition in a number of disorders. In auditory hallucinations, we know that it’s more in what we call the temporoparietal region. So that is activity usually overactive in patients with schizophrenia and so we use stimulation to try and bring that activity down.
JASON OM: Other methods being investigated include magnetic seizure therapy and even a more extreme option of deep brain stimulation. That involves implanting electrodes inside the brain and is sometimes used to treat Parkinson’s disease.
PAUL FITZGERALD: It is far less commonly used in psychiatric disorders like depression, but we are starting to conduct research in this way for patients who have really tried all other anti-depressant strategies. And the – some of the initial research is promising. Although it’s still has a long way to go, we’re very encouraged by what we’ve seen so far in that area.
JASON OM: Would you consider something like a brain implant?
SUSAN PEAK: Do you mean a deep brain stimulation? I’ve read up all on that, and yes, I would consider it, if I felt the research had been properly worked out and so on. I feel it’s still in its infancy in terms of depression at this stage. It’s had good benefits with Parkinson’s disease and other things, but it needs more work done on it, I think, here.
JASON OM: But you’re game?
SUSAN PEAK: Yeah, definitely. You’d be game for anything if you’ve been through this sort of history that I’ve had.