Tag: Depression

Why Are We Still Using Electroconvulsive Therapy?

The idea of treating a psychiatric illness by passing a jolt of electricity through the brain was one of the most controversial in 20th Century medicine.

So why are we still using a procedure described by its critics as barbaric and ineffective?

Sixty-four-year-old John Wattie says his breakdown in the late 1990s was triggered by the collapse of his marriage and stress at work.

We had a nice house and a nice lifestyle, but it was all just crumbling away. My depression was starting to overwhelm me. I lost control, I became violent,” he explains.

John likens the feeling to being in a hole, a hole he could not get out of despite courses of pills and talking therapies.




But now, he says, all of that has changed thanks to what is one of the least understood treatments in psychiatry – electroconvulsive therapy (ECT).

“Before ECT I was the walking dead. I had no interest in life, I just wanted to disappear. After ECT I felt like there was a way out of it. I felt dramatically better.

The use of electricity to treat mental illness started out as an experiment. In the 1930s psychiatrists noticed some heavily distressed patients would suddenly improve after an epileptic fit.

Passing a strong electric current through the brain could trigger a similar seizure and – they hoped – a similar response.

By the 1960s it was being widely used to treat a variety of conditions, notably severe depression.

But as the old mental asylums closed down and aggressive physical interventions like lobotomies fell out of favour, so too did electroshock treatment, as ECT was previously known.

The infamous ECT scene in One Flew Over the Cuckoo’s Nest cemented the idea in the public’s mind of a brutal treatment, although by the time the film was released in 1975 it was very rarely given without a general anaesthetic.

Perhaps more significantly, new anti-depressant drugs introduced in the 1970-80s gave doctors new ways to treat long-term mental illness.

But for a group of the most severely depressed patients, ECT has remained one of the last options on the table when other therapies have failed.

Annually in the UK around 4,000 patients, of which John is one, still undergo ECT.

It’s not intuitive that causing seizures can be good for depression but it’s long been determined that ECT is effective,” says Professor Ian Reid at the University of Aberdeen, who heads up the team treating John.

In the 75 years since ECT was first used scientists have argued about why and how it might work. The latest theories build on the idea of hyperconnectivity.

This new concept in psychiatry suggests parts of the brain can start to transmit signals in a dysfunctional way, overloading the system and leading to conditions from depression to autism.

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According To Study, Magic Mushrooms ‘Reboot’ Brain In Depressed People

Magic mushrooms may effectively “reset” the activity of key brain circuits known to play a role in depression, the latest study to highlight the therapeutic benefits of psychedelics suggests.

Psychedelics have shown promising results in the treatment of depression and addictions in a number of clinical trials over the last decade.

Imperial College London researchers used psilocybin – the psychoactive compound that occurs naturally in magic mushrooms – to treat a small number of patients with depression, monitoring their brain function, before and after.

Images of patients’ brains revealed changes in brain activity that were associated with marked and lasting reductions in depressive symptoms and participants in the trial reported benefits lasting up to five weeks after treatment.

Dr Robin Carhart-Harris, head of psychedelic research at Imperial, who led the study, said: “We have shown for the first time clear changes in brain activity in depressed people treated with psilocybin after failing to respond to conventional treatments.




Several of our patients described feeling ‘reset’ after the treatment and often used computer analogies. For example, one said he felt like his brain had been ‘defragged’ like a computer hard drive, and another said he felt ‘rebooted’.

Psilocybin may be giving these individuals the temporary ‘kick start’ they need to break out of their depressive states and these imaging results do tentatively support a ‘reset’ analogy.

“Similar brain effects to these have been seen with electroconvulsive therapy.”

For the study, published in Scientific Reports on Friday, 20 patients with treatment-resistant depression were given two doses of psilocybin (10 mg and 25 mg), with the second dose a week after the first.

Of these, 19 underwent initial brain imaging and then a second scan one day after the high dose treatment.

The team used two main brain imaging methods to measure changes in blood flow and the crosstalk between brain regions, with patients reporting their depressive symptoms through completing clinical questionnaires.

Immediately following treatment with psilocybin, patients reported a decrease in depressive symptoms, such as improvements in mood and stress relief.

MRI imaging revealed reduced blood flow in areas of the brain, including the amygdala, a small, almond-shaped region of the brain known to be involved in processing emotional responses, stress and fear.

The authors believe the findings provide a new window into what happens in the brains of people after they have ‘come down’ from a psychedelic, with an initial disintegration of brain networks during the drug ‘trip’ followed by a re-integration afterwards.

The Imperial College researchers acknowledge that the significance of their results is limited by the small sample size and the absence of a control/placebo group for comparison.

They also stress that it would be dangerous for patients with depression to attempt to self-medicate.

Professor David Nutt, director of the neuropsychopharmacology unit in the division of brain sciences, and senior author of the paper, said: “Larger studies are needed to see if this positive effect can be reproduced in more patients. But these initial findings are exciting and provide another treatment avenue to explore.”

The authors currently plan to test psilocybin against a leading antidepressant in a trial set to start early next year.

The research was supported by the Medical Research Council, the Alex Mosley Charitable Trust and the Safra Foundation.

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High Sugar Diets Linked To Heightened Depression Risk In Men

doughnuts

Millions of sweet-toothed British men could be making themselves anxious and depressed by consuming too much sugar, a study suggests.

Scientists found that men who consumed more than 67g of sugar per day – the equivalent of two regular cans of coca-cola – increased their risk of mood disorders by more than a fifth compared with those with an intake of less than 39.5g.

Since the average British man has a 68.4g per day sugar habit, according to the National Diet and Nutrition Survey published in 2013, the findings do not bode well for the mental health of the UK male population.




The study ruled out the possibility that the results can be explained by unhappy men comforting themselves with sugary treats.

Lead researcher Dr. Anika Knuppel, from University College London’s Institute of Epidemiology and Health, said: “High sugar diets have a number of influences on our health but our study shows that there might also be a link between sugar and mood disorders, particularly among men.”

”There are numerous factors that influence chances for mood disorders, but having a diet high in sugary foods and drinks might be the straw that breaks the camel’s back.”

There is increasing evidence for the physical damage sugar has on our health. Our work suggests an additional mental health effect.”

depressed

For reasons that are unclear, the study which looked at thousands of civil servants of both sexes found no link between sugar intake and new mood disorders in women.

The findings are based on data from Whitehall II, a major long-term investigation into physical and mental health problems encountered by people working at different levels of the UK civil service.

Sugar consumption was compared with rates of common mental disorders in more than 5,000 men and 2,000 women between 1983 and 2013.

Participants were placed into three groups according to their daily sugar intake. After five years, men in the top group were 23 per cent more like to have developed a common mental disorder such as depression or anxiety than those in the bottom group.

sugar

The top tier men consumed more than 67g of sugar per day and the bottom group less than 39.5g.

British adults consume roughly double recommended levels of added sugar, three quarters of which comes from sweet foods and drinks, said the researchers.

Dr Knuppel added: “Sweet food has been found to induce positive feelings in the short-term. People experiencing low mood may eat sugary foods in the hope of alleviating negative feelings. Our study suggests a high intake of sugary foods is more likely to have the opposite effect on mental health in the long-term.”

Co-author Professor Eric Brunner, also from UCL, said the new sugar tax on soft drinks which takes effect in April 2018 was a “step in the right direction”.

He said: “Our findings provide yet further evidence that sugary foods and drinks are best avoided. The physical and mental health of British people deserves some protection from the commercial forces which exploit the human ‘sweet tooth’.”

sugar

Catherine Collins, from the British Dietetic Association, was one of a number of experts to urge caution. “Whilst the findings as reported are interesting, the dietary analysis makes it impossible to justify the bold claims made by the researchers about sugar and depression in men.”

“More surprising is the lack of reported effect in women, who have a far more emotional relationship with food,” she said. Reducing intake of free sugars is good for your teeth, and may be good for your weight, too. But as protection against depression? It’s not proven.”

Professor Tom Sanders, a nutrition expert at King’s College London, said: “This is an observational study not a clinical trial and its interpretation needs to be treated with caution.”

“While the authors have tried to adjust for the effects of social factors there still is a risk of residual confounding. There is also a major problem in that sugar intake is under-reported in the overweight and obese, which the authors acknowledge.”

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