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?