Brain stimulation offers hope for depression

Published: December 4, 2014

Around 350 million people worldwide have depression. Antidepressant medications are often prescribed to treat the condition, alongside talking therapies and lifestyle changes such as regular exercise.

But a substantial proportion of people either don’t respond to antidepressants, or experience such significant side effects that they’d prefer not to take them.

In search of alternative solutions, researchers around the world, including our team, are investigating transcranial direct current stimulation (TDCS) as an alternative treatment for depression. But this isn’t something you can safely try at home.

Unlike electroconvulsive therapy, TDCS uses very mild electric current to stimulate the brain and has few side effects. The mechanics of TDCS are quite simple, involving a battery, two leads and the electrodes through which the current is passed.

Researchers are yet to fully understand the effects of varying stimulation approaches.
Tinydevil/Shutterstock

The stimulation works by changing the activity of nerve cells in the brain. In depression, the left frontal areas of the brain are often less active than usual. TDCS stimulates this area to restore brain activity.

We’re still evaluating the effectiveness of TDCS, but so far studies have found that TDCS works better than a placebo (or simulated treatment) at reducing symptoms of depression.

When combined with the antidepressant medication sertraline (marketed as Zoloft in Australia), the combination TDCS-drug therapy works better than medication or TDCS alone.

Research has found that among people with depression, a course of TDCS can improve the brain’s “neuroplasticity”, which is the brain’s ability to learn and adapt to changes in the environment.

The therapy has a good safety profile – if administered by clinicians and researchers trained in stimulation technique and safety. Our research team has administered thousands of TDCS sessions without incident.

But this is not the case when TDCS is used in the “DIY” context, with DIY users trying to stimulate their own brains.

This phenomenon is often guided by online forums and websites dedicated to DIY TDCS. Users comment on their own experience and share tips on how TDCS can be used to treat their own depression. People with no medical training and limited understanding of TDCS self-treat their depression and advise others on treatment.

Stronger is not necessarily better.
Ian Ruotsala/Flickr, CC BY-NC-SA

So, what can go wrong?

The most obvious concern is that poor technique and improper electrode placement could cause skin burns.

What’s more concerning is the ability for TDCS to produce lasting changes in brain functioning. Depending on how TDCS is given, these changes could be good or bad.

A DIY user could, for example, cause lasting impairment to their thinking and memory. For people with severe depression, incorrect application could worsen their condition or induce a hypomanic (manic) episode.

When it comes to medications, it’s important to get the right dose and dosing schedule. That’s why this role falls to qualified clinicians and researchers. The same goes for TDCS: current intensity, electrode size and position, and the duration and frequency of the stimulation determine the effects in the brain.

The relationship between dosing, intensity and position is highly complex. This isn’t a simple case of “the stronger the better”. Even researchers are yet to fully understand the effects of varying stimulation approaches and much more research is needed.

As with other forms of treatment, TDCS is not suitable for everyone. In clinical research trials, participants are screened for suitability to receive stimulation and their likelihood of responding to treatment. The stimulation is carefully controlled and the participants’ mood is carefully monitored during and after the course of treatment.

A substantial proportion of people don’t respond to antidepressants, or experience significant side effects.
Divine Harvester/Flickr, CC BY-NC-SA

TDCS represents a promising future, where simple and cost-effective treatment for depression is possible, without drugs. Researchers worldwide are continuing to study this experimental treatment, which may one day become a conventional treatment for depression.

The acceptance and popularity of TDCS among the general community is encouraging. But TDCS is still experimental and isn’t safe to administer at home. DIY users are not trained in proper technique nor are they trained to identify, prevent or deal with unexpected outcomes.

If you’re interested in participating in our TDCS trials for depression, contact the research team at the Black Dog Institute for more information.

This article was originally published on The Conversation.
Read the original article.

Could depression be caused by a virus?

Published: December 3, 2014

Dr. Turhan Canli, associate professor of integrative neuroscience at Stony Brook University, makes a case for reconceptualizing depression as an infectious disease caused by foreign invaders like parasites, bacteria or viruses that make their way into the body and cause changes in the brain.

The Huffington Post spoke to Canli about his theory and what it might mean for future treatment.

Link here to read Why This Psychologist Thinks Depression Is An Infectious Disease

How Lack of Sleep Impact Different Age Groups

Published: October 30, 2014

This time of year most of us enjoy the extra hour of sleep as we get as we turn our clocks back, but it’s not nearly enough to make up for the massive amounts of sleep we are losing throughout the rest of the year.

“We are a sleep-deprived society, and we often pay for that lack of sleep in ways we may not realize,” said Dr. Aneesa Das, assistant director of the Sleep Program at The Ohio State University Wexner Medical Center. “Depending on your age, it can affect everything from your complexion to your weight to your heart, and can lead to some very serious medical issues,” she said.

“For children, sleep deprivation can lead to behavior problems, trouble focusing and learning in school and it can affect their immune systems,” said Dr. Aneesa Das, a sleep medicine specialist at Ohio State’s Wexner Medical Center. “Chronic tiredness makes it harder to cope and process what’s going on around you.”
When children enter the teen years, sleep becomes a bigger issue. Das says a teen’s circadian rhythm, or internal body clock, tells them to stay awake later and sleep later than children and adults do. She says only 15 percent of teenagers get the recommended sleep they need.

“Sleep is time the body uses to restore itself. Muscles and other tissues repair themselves, hormones that control growth, development and appetite are released. Energy is restored and memories are solidified, so we need to try to get regular sleep on a regular basis,” Das said.

Source:The Ohio State University Wexner Medical Center

Less than half of Canadians exercise to relieve stress

Published: October 7, 2014

As fall brings with it dark mornings, getting up is getting harder. My first inclination when my alarm goes off at 6.00am is to roll over and go back to sleep. But that little voice in my head starts reminding me gotta get up, gotta hit the gym. Argh! its hard, but this is something I have to do, something I need to do. The older I get, the harder it gets, but the benefits outweigh the struggle to resist, and go back to sleep.

A research study out of McMaster University has found that only 40 per cent of Canadians exercise to cope with stress.

The researchers analyzed data from Statistics Canada’s Canadian Community Health Survey of nearly 40,000 Canadians 15 and older. Of 13 coping behaviours or strategies polled, exercise was ranked eighth, meaning people were more likely to cope with stress by problem-solving; looking on the bright side, trying to relax, talking to others, blaming oneself, ignoring stress or praying, rather than being active.

“We know stress levels are high among Canadians, and that exercise is effective at managing stress and improving health and well-being, so the fact exercise is number eight and that less than half of the population use it is worrisome,” said principal investigator John Cairney, a professor of family medicine, and psychiatry and behavioural neurosciences, at McMaster’s Michael G. DeGroote School of Medicine.

The study, published in the Journal of Physical Activity and Health, also found that younger, single, more educated and more active adults as well as women were more likely to use exercise for stress release. As well, the individuals who reported using exercise to combat stress were more likely to endorse other positive coping strategies and less likely to use alcohol or drugs for coping.

Encouraging exercise, especially in groups identified as being less likely to use exercise to cope with stress, could potentially reduce overall stress levels and improve general health and well-being, said Cairney.

“Exercise as a coping strategy for stress can be a ‘win-win’ situation because there are both mental and physical health benefits.”

ᔥ McMaster University

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Brain stimulation offers hope for depression

Could depression be caused by a virus?

How Lack of Sleep Impact Different Age Groups

Less than half of Canadians exercise to relieve stress