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Brain Neuroplasticity and Treatment Resistant Depression

Allan Schwartz, LCSW, Ph.D.

On August 14 2009 I posted an enthusiastic article about the latest findings in brain research. That article can be found here:

http://www.mentalhelp.net/poc/view_index.php?idx=119&d=1&w=5&e=29804

One reader correctly pointed out that we have lots of articles that encourage us to be enthusiastic about having hope for treatment resistant depression. We can now cross from hope into reality.

There are a significant number of people who do not get any benefit from psychotherapy of any type, or from any of the anti depressant medications or from any combination of medications. Even when electro convulsive therapy is used these patients may feel temporarily better but return to their depressive state 6 months to a year later. Truly, these are people whose depression is treatment resistant.

Last week I wrote about the amazing plasticity of the human brain. In fact, it is so amazing that stroke patients are being returned to normal functioning as a result of medical science using the newly discovered ability of the brain to repair itself.

Now, these discoveries are being used to help those with treatment resistant depression to recover and live normal lives. Here is how it works:

Thanks to fMRI pictures of the human brain, medical researchers learned that in some people with depression, large parts of the Prefrontal Cortex are turned off. In other words, the neurons in that part of the brain are under-functioning.

A non invasive type of brain stimulation is being used at the University of Michigan Department of Psychiatry to turn those prefrontal brain neurons back on and help patients become free of their resistant depression.

The non-invasive stimulation is called TMS. TMS stands for Transcranial Magnetic Stimulation. The magnetic current from this machine travels into the neurons of the brain and stimulate the underactive nerve cells. This is achieved without any surgery at all. In order to make certain that the newly awakened brain cells remain awake, an rTMS is used. This is stands for repetitive Transcranial Magnetic Stimulation.

The research at the University of Michigan included 10,000 patients. It was found that the treatment was well tolerated by patients, did not have any of the uncomfortable side effects that go with medications, such as dry mouth and lowered libido, and was successful in relieving depression for people who formerly could get no relief. In addition, it has been found to be a safe.
 
What Should You Do?

If you are one of the people with a history of depression that has been resistant to any other treatment, you should consult your psychiatrist about rTMS.

The only caution that I am alerting everyone to is that I do not know when this new treatment will become readily available. In fact, it may be but I doubt that. I would also assume that, when it is ready for the public, the treatment would be done on an ooutpatient basis at the hospital, at least, that is my guess.

Conclusion:

This is not "pie in the sky" meaningless hope. It is merely a matter of time before this treatment is easily availabe for the public. This is just one example of the extraordinary work being done to help people with all tyes of disabilities.

Your comments, questions and your experiences with depression are welcome and encouraged.