Alternative to talk or pharmacological therapies for depression?

For many of my clients, medications are necessary for their moderate to severe depression. With SSRIs or mood stabilizers, they are able to function at home and at work and can better benefit from talk therapy. But in every case my clients report side effects from their meds. It is always a bit of art-form to balance benefits and side effects. That is the world we live in and the best we can do now. One of the key problems with all psychopharmacological interventions is that drugs provide a systemic solution when often we may need a targeted approach. Consider a person with ADHD who takes a stimulant that will help them focus in class yet must deal with increased blood pressure, heart rate and potential for insomnia. The stimulant does not just target the frontal lobe but impacts the whole body.

Wouldn’t it be great if we could target an intervention to a particular part of the brain?

“The brain is not a bowl of soup and you add the chemical and you stir,” she says. “Chemicals work within networks, within systems, within pathways. And where in the brain a chemical may be working is as important as knowing what chemical you should use.”

I read the above quote in this news item about the problem of rumination in treatment resistant depression. Helen Mayberg, author of the above quote, is researching Broadman Area 25 and its connection to the problem of rumination–where a person struggles to turn off negative thoughts about self and the world. She and other researchers are wondering why some people do well with talk therapy while others seem not to benefit. Instead of looking at the possibility of a less helpful form of talk therapy, they wondered whether the problem is that the person cannot get away from their negative thoughts enough to engage in the work of counseling.

One of the interventions being tried is to practice disconnecting from ruminations by paying attention to what is going on in the present. To help with the learning of this skill one researcher is testing whether 5 sessions of having an electrode on your wrist create an itching sensation while the patient practices paying attention to a decreasing amount of electrical stimulation.

Sound crazy? It just might be. I am always wary of any “5 sessions or less” advertisement. But before we toss out the idea, if a targeted treatment could help turn down the volume on a rumination, wouldn’t that be a help to many?


Filed under Depression, news, Psychiatric Medications, Psychology, Uncategorized

5 responses to “Alternative to talk or pharmacological therapies for depression?

  1. Tom

    Interesting. Here’s another alternative – but going in another direction – on curing fear with propanadol. There’s seems to be a theme of re-routing neural pathways – by various means…


    • There certainly is some interesting research on the use of beta-blockers with panic. Most do not experience this kind of benefit. But we keep trying to figure out what works for most people.

  2. I have concerns with Mayberg’s other interests, namely deep brain stimulation for treatment resistant depression. Irving Kirsch’s research, especially “The Emperor’s New Drugs,” effectively challenges the the overall effectiveness of antidepressants, in my opinion.Look at Peter Breggin’s work for another perspective on mood stabilizers. Try his website: Also look at Joanna Moncrieff, “The Myth of the Chemical Cure” or her website: Moncrieff and Breggin have made several of their peer-reviewed papers available on their websites.

    On my blog I’ve written about concerns with deep brain stimulation, antidepressants and Kirsch, Some on Moncrieff’s approach to medication and other psychiatric issues:

    • Yes, much is not known yet. Still, there may be things here that still need exploring. One of our challenges is that some of these interventions (meds or magnets or DBS) have had some small positive benefits even as they have yet to find wider success. 6 years ago, my wife was advised to have chemo and radiation for her breast cancer even though the cancer expert told her it was probably not needed and that in ten years we’d likely have had a better test to determine if she was in the 10 percent who would need it or the 90 percent who didn’t. We had to weigh the shortening of her life by cancer vs. possibly shortening her life with some seriously damaging chemicals and radiation. Individual choices are made in those moments. The same is true in psychiatric interventions. Antidepressants? Choices are made and benefits are had by some interventions that do not help many others.

      • It seems to be more the exception than the rule that the pros and cons of psychiatric medication are discussed with patients as were the options with your wife and her cancer treatment.

        The science behind a cancer diagnosis and treatment is significantly more valid than the science behind psychiatric diagnosis and the proposed treatments of these “disorders.” And I believe there is convincing scientific evidence to question much of the received wisdom on diagnosing and treating mental health disorders.

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