Almost seven percent of U.S. adults—about 15.7 million people—are diagnosed with major depression disorder, according to the National Institute of Mental Health (NIMH). The Centers for Disease Control and Prevention report that depression causes 200 million lost workdays each year at a cost to employers of between $17 billion and $44 billion. The statistics for anxiety disorders are not great either. The most common mental illnesses in the U.S., they affect 40 million adults age 18 and older, costing the economy more than $42 billion a year.
In my twenties, I developed panic disorder. I failed to get better on most medications and therapy. As I reported in an article earlier this year, it took me years to find a medication that worked. Because it took me so long to be diagnosed and treated properly, I have always been interested in alternative treatments for depression and anxiety.
Two years ago I attended two sessions at the World Science Festival on the use of electrical therapy to treat depression and anxiety. The first event was Spark of Genius? Awakening a Better Brain, a panel discussion moderated by ABC News Chief Health & Medical Editor Richard Besser. The panel discussed what is known about treating the brain and the ethical and legal complications of brain enhancement. (You can watch it online at the World Science Festival website.)
The second panel, "Electric Medicine and the Brain" was moderated by John Rennie, former editor in chief of Scientific American His panel focused on the use of "electroceuticals," a term coined by researchers at GlaxoSmithKline to refer to all implantable devices being used to treat mental illnesses and being explored in the treatment of metabolic, cardiovascular and inflammatory disorders.
I am excited about the potential of these treatments because the existing treatments such as Prozac, Zoloft and Lexapro don't work for everyone. They didn't work for me. Talk therapies, especially cognitive behavioral therapy can also be effective, but they are expensive and insurance companies place limits on the number of sessions available to patients. Because of this, and the desire for a quick fix, most people with depression and/or anxiety opt for drugs.
But there are drawbacks to medication. First, it can take up to six weeks for antidepressants to work fully (they treat both depression and anxiety disorders). They have side effects such as weight gain, sedation and sexual problems. Antidepressant medications are contraindicated in pregnant women. The U.S. Food and Drug Administration (FDA) has ruled they should not be used for children and young adults up to age 25 as they increase the risk of suicidal ideation. And they don't always work either. A study in the Journal of the American Medical Association found that compared with placebo, antidepressant medications benefited people with severe depression but that the effects were "minimal or nonexistent, on average, in patients with mild or moderate symptoms."
Given the limitations of treatments for anxiety and depression, I was surprised to read the mostly negative view of electrical treatments by John Horgan in these pages. In his article, he writes "rather than developing ever-more-potent therapies, psychiatrists and others in the mental-health industry seem merely to recycle old ones." While it's true that electrical cures are not new, there is good evidence that they are useful and should have a place in the treatment of mental disorders.
Transcranial magnetic stimulation (TMS)—which noninvasively administers brief, magnetic pulses to the brain—is a less "shocking" approach than ECT, and is being used at major medical centers. The treatment, which must be done under medical supervision, consists of passing high currents through an electromagnetic coil adjacent to a patient’s scalp. The targeted magnetic pulses stimulate the circuits in the brain that are underactive in patients with depression, with the goal of restoring normal function and mood. The FDA has cleared TMS for the treatment of major depressive disorder in adults for whom medication did not work. For most patients, treatment is administered daily for four to six weeks, 40 minutes a session. Studies, including one by the National Institute of Mental Health (NIMH) have demonstrated its efficacy and safety in treating major depression.
For those interested, the NIMH has an excellent review article of other brain stimulation therapies including Deep Brain Stimulation and Vagus Nerve Stimulation as well as more information on TMS.
I have been using the Fisher Wallace Stimulator, a portable, battery-powered generator permitted by the FDA for symptomatic relief of insomnia, anxiety and depression, and for treating chronic pain (although the agency recently proposed imposing new restrictions on such devices). It is a cranial electrotherapy stimulation (CES) device which stimulates the brain to produce serotonin and other neurochemicals. It is designed to be used for 20 minutes twice a day and may be used with or without medication in consultation with your doctor.
For me, the best part is that unlike ECT, TMS or other therapies, the Fisher Wallace Stimulator can be used at home and there is no risk of seizures. Your doctor has to prescribe it and you can buy the device on the company website for $699 (there is a $100 discount for Medicare, Medicaid, Veteran and First Responder Families) but can return it for a full discount if it doesn't work within 30 days. Some insurance plans will pay for the device when it is prescribed for chronic pain. Mine did.
The Fisher Wallace Stimulator been shown effective in many studies including one in the Journal of Affective Disorders. The results of a pilot study for the treatment of bipolar disorder was published last year.
I have been using the Fisher Wallace Stimulator for about six years to help with my anxiety and chronic pain. I occasionally use it for insomnia as well. When I travel to a different time zone, I find it helpful with jet lag, although it is not one of the conditions it was set out to treat. I find it relaxing. I don't feel like I am "shocking my brain," and it reminds me of how I felt when I practiced transcendental meditation in college.
I agree with Horgan that we need better treatments for depression and anxiety. But I think that although much remains unknown, electrical stimulation of the brain is a good alternative for many people, especially those who have failed to respond to traditional therapies.