The Walrus >> New Treatment for Depression >> Mapping the Blues >> science

This is one of most interesting articles about depression that I've read. It covers the history of depression treatment, some very interesting research into brain patterns shown in depressed patients, and a preliminary review of deep-brain stimulation (DBS) treatment.

Here is the transcript of an interview with Dr. Helen Mayberg, the doctor profiled in the earlier article.

We have a ways to go before DBS or any similar treatment is going to be generally available and, more importantly, proved to be effective. Nevertheless, the idea of evidence-based treatments - where we can see the effect of treatment as it happens, rather than waiting the days, weeks, and months that are now a part of the current treatments - is exciting and hopeful.

The benefits of mindfulness may only be in the mind

I've read a lot about mindfulness over the years. It's the basis of stress reduction course that I took last summer. Well, it appears, at least in the case of a recent article by Ellen Langer, that mindful exercise may not be any better for you than plain, old drudge work.

In Exercise Study, Occam's Razor Shelved in Favor of Buddha's Magic Wand - 60 Second Science

Fifty-minute walks, three times weekly for Treatment Resistant Depression

In addition to the cardio workouts resulting from a recent string of snowstorms, Marley and I have been taking longer walks, three miles or more. We're only a couple of weeks into the new regimen (along with an increased dosage of Emsam) and we haven't seen a lot of improvement yet. Nevertheless, it can't hurt (except for the falling-down part that often comes with walking on icy roads).

Ref: Dr Shock MD PhD: 3 Times Walking 50 minutes a Week for Treatment Resistant Depression

When Big Pharma fails, there's Toyota.

We're learning that depression is can foreshadow intellectual decline in older people, possibly by diminishing the executive functions of the brain. This may have a longer-term impact that lasts into our older years. Fortunately, Toyota is developing cars that may be able to compensate for our shortcomings.

Get Healthier and Happier - US News and World Report

Get Healthier and Happier - US News and World Report: "Gradually, many mental-health practitioners are coming to believe that adjusting brain chemistry with medication isn't enough—that depression is a complex chronic disease, akin to diabetes, requiring lifestyle changes and ongoing monitoring to address underlying causes."

If we have so many answers, why does depression still exist?

Lots of people have lots of ideas about origin and treatment of depression. It can get very confusing and disheartening. If we refer to depression as an illness, for example, we're taking sides, implying that the symptoms of depression are caused by malfunctions in the brain and body. Treatment, then, typically comes in the form of something from the outside - medicine, magnetic stimulation, electroshock, or, in the rarest of cases, surgery.

Another camp says that depression is largely a result of societal behaviors that isolate us from one another. Throw in bad exercise and diet habits and you have a deteriorating body and brain that naturally leads to depression and anxiety. Meds demonstrate the marketing prowess of Big Pharma more than good medicine. (Right on cue, The Onion explains it all.) The treatment plan (or, even, the cure) for depression winds up being, "Don't do that." If you're thinking that you're depressed, think about something else. Call upon your higher power. Load up on Omega-3 fatty acids, run a 5K, and you'll be fine.

All of which can leave people with depression feeling as though they're powerless over an unseen medical condition or that they're failures because they can't apply a few simple principles to get and stay well. Conversely, when one or more of these techniques leads to a time without symptoms of depression, one's tempted to say, "I'm a good patient. I know what to do."

And all that, sounding like hiking boots in the washing machine, is how I'm feeling. We're expecting a lot of snow today, so I plan to talk with my psychiatrist on the phone, rather than in person. We'll probably increase the dosage of Emsam. Marley and I will go for a long walk. There's plenty to be grateful for. Whatever works is good for today. Whatever doesn't work, well, we'll try something different tomorrow.

Aqua's ECT treatments

A well-told tale about Aqua's experiences with ECT and the depression and meds that frame it: Vicarious Therapy: Me and ECT.

(via Dr. Shock)

The Neurobiology of Treatment-Resistant Depression

It's easy to get discouraged with the news that "Treatment-resistant unipolar major depression appears to be the rule rather than the exception." The Neurobiology of Treatment-Resistant Depression

Nevertheless, we keep going. The Emsam is showing good results so far. I haven't more good than tough days, even though I haven't slept well the last two nights. I have an appointment with my psychiatrist on Thursday; we'll discuss the option of increasing the dosage. My biggest concern with the increased dosage is that the dietary restrictions come into play at the next level. It's an odd world when bananas and raisins are proscribed, but Cheez Whiz is permitted. I'm probably going to have to stay away from Chinese food because anything worth eating is made with soy sauce. Of course, we might conclude that I should stay at this dosage for a while longer, making dinner safe for hot and sour soup.

ECT Videos

I've mentioned a couple of these before, but it's good to have the links in one spot: Dr Shock MD PhD: 9 Videos on ECT, electroconvulsive therapy.

Something to keep you awake at night

So, if the amount that you sleep either increases or decreases, you'll face an increased mortality risk. And then they tell you that it's not a good idea to use medications for sleep, that fixing sleep hygiene is the key.

NYT - Self-Nonmedication

Having recently come off of Effexor, I can confirm that this writer's withdrawal experiences are consistent with mine. I can also confirm that it's my opinion that it's dumb to wean oneself off of such a medication by using reduced-dosage samples squirreled away from whatever source.