Imagine a crushing sadness so severe it keeps you from eating, sleeping, or socializing. Though you can’t sleep, you lack the energy and the will to get out of bed. Everyday decisions, like which clothes to wear, leave you paralyzed. You’ve no desire to do the things you once thought were fun; in fact, you can’t bring yourself to do much of anything. Now, add to all that the realization that you’ve tried everything known to medicine, it hasn’t worked, and there’s a good chance you won’t feel any different. Ever.
“I had nothing to lose,” says Karmen McGuffee, who suffered from severe depression for a decade and was hospitalized five times for it. So she had surgeons cut open her neck, gently wrap an electrode around one of the nerves there, and plug the electrode into a pulse generator, which they slipped under the skin of her chest. About every 5 minutes, the pocket-watch-size device sends a buzz of current through the nerve and into her brain.
Six months after doctors switched on the pulse generator, called a vagus nerve stimulator, McGuffee’s world looked totally different. “I had no idea that life didn’t have to have a dark veil over it all the time,” she says. Once unable to concentrate enough to read a newspaper, McGuffee is now an executive secretary.
Depression is distressingly common, affecting more than 120 million people around the world and sucking tens of billions of dollars out of the global economy through the cost of care and lost productivity. It’s also deadly. Every year 850 000 people worldwide take their own lives, and 9 out of 10 of them are suffering from depression, another mental illness, or substance abuse. Statistics show that of those who had had treatment for depression just through visits to a doctor’s office, 2 percent ultimately committed suicide, as did 4 percent of those who had to be hospitalized for depression.
Twenty-five percent of people with depression have no access to any form of mental health care; of those who do have access to care, only a quarter seek treatment. Of those who consult doctors, some 80 percent find relief in the form of drugs or some kind of talk therapy, such as cognitive therapy. But for the restâ€”people like McGuffee, prone to the most severe and chronic forms of depression, about 11 million of them in the developed world aloneâ€”drugs don’t work.
For decades, the only other option for these people was electroconvulsive therapy, which because of the frightening side effect of amnesia is often rejected by patients. But this grim outlook is at last beginning to change. McGuffee was one of the first to benefit from a new crop of electromagnetic brain stimulation technologies that psychiatrists are testing, with the hope of curingâ€”or at least helpingâ€”patients for whom little else works. By electrically manipulating specific portions of the brain with implanted electrodes, electric current, or magnetic fields, doctors aim to succeed where drugs fail, by producing long-lasting changes in the brainâ€”and to do it without electroshock’s significant side effects.
For a variety of reasons, including the large number of potential patients and the accumulated knowledge of how the disease works, depression is the primary target of most of these technologies. But some of these methods are already showing great promise for treating such other mental maladies as bipolar disorder, obsessive-compulsive disorder, and bulimia.
Does this kind of technology scare you? One psychiatrist in the story talks about how these new therapies need to be administered with a great deal of caution, and I would tend to agree. What are your thoughts?