Description: Perhaps you have heard about the use of ECT (electroconvulsive shock therapy) to treat “treatment resistant depression. It involved(s) the induction of a grand mal seizure (random firing of all neurons in the brain) through the application of electrical stimulation of the brain. Why does it work (when it does)? It seems to “rest” the neural systems in the brain. Taking the notion of a neural reset further is the experimental treatment for anxiety and depression described by Heather Armstrong, a woman who went through the treatment, in the excerpt from a radio interview linked below. A few details of the treatment are covered in the interview (more in the references section below) but most striking is Heather’s vivid description of what it was like to awaken from the treatment and in particular after her fifth treatment. One of the huge benefits of case studies (despite the limits to their generalizability) are the rich insights they can provide into the subjective experience of disorders such as depression and of the subjective impact of treatments that seem to work.
Source: This woman went to the brink of death – and back – to treat her depression, The Current, CBC Radio.
Date: May 7, 2019
Photo Credit: Angela Monson; Gallery Books/Simon & Schuster.
The induction of a comatose state using an anesthetic called propofol is thought to act on symptoms of anxiety and depression by resetting or reawakening the brain’s inhibitory systems. Heather’s description of it as “something marvelous” is quite striking. Of course more research is needed but the early returns on this experimental treatment seem quite promising.
Questions for Discussion:
- What do ECT and propofol do when used as a treatment for “drug treatment resistant” depression?
- Is the phrase “neural reset” simply a literary shorthand or is it a useful description for the treatment described in the interview/story linked above?
- What sorts of research are needed going forward if we are to both understand and properly regulate this form of treatment for anxiety and depression?
References (Read Further):
Eranti, S. V., Mogg, A. J., Pluck, G. C., Landau, S., & McLoughlin, D. M. (2009). Methohexitone, propofol and etomidate in electroconvulsive therapy for depression: a naturalistic comparison study. Journal of affective disorders, 113(1-2), 165-171. http://www.academia.edu/download/12139596/Methohexitone_Published.pdf
Mickey, B. J., White, A. T., Arp, A. M., Leonardi, K., Torres, M. M., Larson, A. L., … & Sakata, D. J. (2018). Propofol for treatment-resistant depression: a pilot study. International Journal of Neuropsychopharmacology, 21(12), 1079-1089. https://academic.oup.com/ijnp/article/21/12/1079/5107793
Tadler, S. C., & Mickey, B. J. (2018). Emerging evidence for antidepressant actions of anesthetic agents. Current Opinion in Anesthesiology, 31(4), 439-445.
Ogawa, K., Uema, T., Motohashi, N., Nishikawa, M., Takano, H., Hiroki, M., … & Takeda, M. (2003). Neural Mechanism of Propofol Anesthesia in Severe DepressionA Positron Emission Tomographic Study. Anesthesiology: The Journal of the American Society of Anesthesiologists, 98(5), 1101-1111. http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1942717