CAT & PET Scans for Diagnosis Bipolar Disorder

CAT (sometimes referred to as CT, computer axial tomography) scans are a diagnostic tool for problems in the brain. It’s a painless procedure, takes less time than an MRI, and doesn’t have the risks from the magnetic fields. It is used mainly to rule out other disorders before a diagnosis of bipolar disorder can be made.(1) Generally if there is something found abnormal on the CT scan, an MRI is ordered.

 “Information gathered from a CT scan isn’t useful in making a bipolar diagnosis”

 PET (Positron Emission Technology) Scans work differently. It uses radiation (eek!) or nuclear medicine imaging to produce a 3-D picture of the human body.(2) The machine detects pairs of gamma rays emitted indirectly by a positron(3) emitting radionuclide, which is in the body on an active molecule. The images are constructed on a computer, and many machines take a CT scan and X-ray during the procedure. Again, this is a painless procedure, just boring.

 PET scans are used to diagnose health conditions, or find out how an existing condition is developing, to see how the treatment is working.

 And now onto the mental illness part.

Pharma companies have been saying mental disorders are chemically based for years, but actually, there isn’t really any proof.(4) A PET scan is changing that, they are finding interesting results comparing PET scans from the mentally interesting to the normals.

 Research:

  • Depressed brains are more active

  • PTSD sufferer’s brains are less active

 The other side of the fence(5)

What Brain Scans Can Do

  • Show damage to brain tissue, the skull, or blood vessels in the brain

  • Be used with other medical tests to help doctors find the right diagnosis for mood and behavioral problems

  • Help researchers study healthy brain development, effects of mental illnesses or effects of mental health treatments on the brain.

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What Brain Scans Cannot Do

  • Diagnose mental illness when used by themselves

  • Predict risk of getting a mental illness.

 There is a lot of controversy surrounding brain scans and mental illness. Some say yes, some say no. Specific scans can show the damage done by drug use, however. They are mostly used to rule out neurological disorders. Perhaps in future years, technology will allow us to see into the brain more carefully.

 

 

 

 

 

  1. http://www.answerbag.com/q_view/1928160

  2. http://www.medicalnewstoday.com/articles/154877.php

  3. Positively charged particles

  4. http://gaia-health.com/gaia-blog/2011-11-27/pet-scans-proof-that-depression-is-a-chemical-imbalance-or-a-psychiatric-delusion/

  5. http://www.nimh.nih.gov/health/publications/neuroimaging-and-mental-illness-a-window-into-the-brain/neuroimaging-and-mental-illness-a-window-into-the-brain.shtml

 

Can EEG (Electroencephaolography) Be Used as a Diagnostic Tool?

Some say yes, some say no, many say maybe.

First, let’s examine what Electroencephaolography (I’m going to call it an EEG, its way easier to type that) is. Electrodes are painlessly stuck to your scalp (this sucks if you have long hair, washing the goop out later) to detect electrical activity in your brain(1). There are always active brain cells, even when you’re sleeping. This test is commonly used to rule out seizure disorders, or determine what part of the brain is causing the seizure.

However, an EEG is not for use to diagnose mental illness, but there are studies that show the electrical circuits in the brain that are different in the mentally interesting than the “normal population”.

The EEG was used to test schizophrenics, a condition similar to bipolar disorder that has a “hybrid” of schizoaffective disorder. The study of patients indicates a higher number of them with abnormal records decreased in alpha activity. There are left side abnormalities, and some coherence abnormalities. (2) Further testing needed.

This study(3) claims that schizophrenia can be diagnosed before major symptoms happen, using EEG technology.

 

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“What we found, in terms of disease, was quite striking – defects in the genes that encode these human synapse proteins are really a major cause of disease,” he said. “There are over 135 nervous system diseases, psychiatric and neurological, that arise because of defects in these synaptic proteins. These are common and rare diseases – schizophrenia, bipolar disorder, autism.”

Although there are those doubting the EEG being used a diagnostic tool, it could help in the future as research continues, to decide on the best medications to use, and also to create new medications.

(1) http://www.mayoclinic.com/health/eeg/MY00296
(2) http://www.eeginfo.com/research/bipolar_main.html
(3) http://www.guardian.co.uk/science/2010/jul/05/brain-scans-predict-schizophrenia

Diagnostic Tools Part 1 – MRI and fMRI

They’re always looking for a way to diagnose mental illness using the physical body, assuming the physical and mental are somehow interconnected. I’m going to go over popular diagnostic tools and sho how effective they are in diagnosing, or confirming a bipolar disorder diagnosis.

 

Image

MRI

Magnetic resonance imaging is in the works of becoming a diagnostic tool for bipolar disorder, according to the researchers at the Royal College of Psychiatrists International Congress.(1)

A function MRI (or fMRI) can be used to scan the neural pathways and DTI (Diffusion Tension Imaging) can scan the brains white matter.

So far, scans of brains of those with depression or bipolar disorder have shown differences from the brains of those who do not have these conditions. “Functionally coupled” activity is shown in two parts of the brain: the amygdala(2) and the pre-frontal cortex(3).

Those with bipolar disorder had an increased right lateral ventricular(4), left temporal lobe(5) and right putamen(6) volume. If the patients were taking lithium, hippocampal(7) and amygdala(2) volume were significantly increased. Cerebral volume reduction was associated with illness duration in bipolar individuals.

 

In conclusion, there is hope out there for a fairly simple diagnostic test for bipolar disorder. It can even be used to predict bipolar disorder.

 

 

  1. http://www.medicalnewstoday.com/releases/192747.php

  2. The amygdala processes emotions.

  3. The pre-frontal cortex is important for emotional regulation.

  4. Protects the brain from trauma.

  5. Information retrieval, reading, emotional stability, memory, sensory processing

  6. Regulate movements and influence various types of learning.

  7. Plays a role in memory, spatial navigation and control of attention.

Scary Side Effects Part 2 – Neuroleptic Malignant Syndrome

I’m not writing this because I’m anti-medications or anything. I’m a big fan of being on my medications or I wouldn’t be functional at all. But when you introduce different chemicals into the body, it can affect more than what it’s meant to do. I took Seroquel for many, many years, and eventually switched to Zeldox (Geodon). I switched back to Seroquel, and at 400mg, I could hardly get out of bed to go to the washroom after I took my night dose. The highest dose I had been on was 900mg. 300Mg’s 3 times a day.

Then I noticed some weird side effects. I couldn’t swallow. Then I would start to panic, get up, drugged out, drink water, try to sleep, have to pee, wash rinse repeat. I also noticed fluttering in my chest, my heart kept beating “wrong”. Too fast, too slow. I would panic until I was eventually knocked out by the ‘quel but it took a while since I’m quite the insomniac. Upon hearing my symptoms, the Seroquel was discontinued and I heard of something called neuroleptic malignant syndrome, and it fit. I mostly had symptoms of dysautonomia.

 What is Neuroleptic Malignant Syndrome?

NMS is a neurological disorder generally caused by some (not all, and very rarely) antipsychotics.(1) It is potentially deadly and starts in the first two or three weeks of antipsychotic use. It is a bit more common in the original antipsychotics (for example, Thorazine), and happens on the occasional atypical antispychotic, which is the new treatment for psychosis and mood stabilization.(2)

 What are the symptoms of NMS?

  • high fever, sweating, unstable blood pressure, stupor, muscle rigidity and dysautonomia(3).

  • Dysautonomia is a disease in itself. It is a medical term used for a group of conditions caused by the autonomic nervous system (ANS). Symptoms include:

  • — tachycardia (extremely fast heart rate)
    — bradycardia (slow heart rate), palpitations
    — chest pain
    — dangerously low blood pressure
    — wide swings/sudden drops in blood pressure
    — orthostatic intolerance (the inability to remain upright)
    — excessive  fatigue exercise intolerance
    — dizziness, fainting/near fainting
    — gastrointestinal problems
    — nausea, insomnia
    — shortness of breath
    –anxiety tremulousness
    — frequent urination
    — convulsions
    — cognitive impairment
    — visual blurring or tunneling
    — migraines

What causes NMS?

An adverse reaction to an antipsychotic or neuroleptic drug.

What is the treatment?

Immediate discontinuation of the medication, the symptoms are treated (mostly the fever) and a dopamine agonist can be useful. There is no diagnostic test.

What happens if it goes untreated?

It can be fatal.

  1. http://www.ninds.nih.gov/disorders/neuroleptic_syndrome/neuroleptic_syndrome.htm

  2. http://emedicine.medscape.com/article/288482-overview

  3. http://www.uptodate.com/contents/neuroleptic-malignant-syndrome

  4. http://www.medicalnewstoday.com/releases/76785.php

Different Diagnosis and Co-morbid Disorders

Differential Diagnosis

Determination of which one of two or more diseases with similar symptoms is the one from which the patient is suffering. Also called differentiation.” (1)

 

Other conditions to be considered before a bipolar disorder diagnosis are as follows:(2)

Epilepsy

Epilepsy is a disorder of the brain caused by sudden, large discharges of electrical impulses from brain cells. This disturbance affects the brain’s normal functions and produces changes in a person’s movement, behavior or consciousness.

 

Fahr Disease

A rare, inherited, progressive brain disorder that is characterized clinically by involuntary movements, prolonged muscle contractions, anddementia. It is characterized by abnormal deposits of calcium in the basal ganglia and cerebral cortex of the brain. There is no cure for Fahr syndrome.Treatment is directed toward relieving symptoms.

 

AIDS

As HIV and AIDS progress, many symptoms show up, some of them mental, including mood swings, depression and suicidal ideation.

 

Brain Tumor/Head Injury

Any condition affecting the central nervous system can affect emotional stability as well.

 

Medications

Many people don’t see a doctor when they’re manic, because it has a tendency to feel good, but they’ll go during a depressed episode. Often, the bipolar disorder is “missed” and they are given medications for depression (usually an SSRI or SNRI) which can cause irritability, anger, and mixed or manic episodes.

 

Circadian rhythm desynchronization

An interruption in the regular recurrence in cycles of about 24 hours from one point to another, such as certain biological activities that do this regardless of long periods of darkness or other changes in environmental conditions.

 

Sodium Imbalance

Too much or too little sodium in the system can cause drastic mood swings, confusion and irritability.

 

Cushing syndrome

This is an imbalance in the pituitary gland, which is part of the brain(6). This causes depression by causing hormonal and metabolism changes, which can cause dramatic mood swings, or just major depression.

 

Hyper or hypothyroidism

If too much of the hormone is found, it causes nervousness. If too little of it is found, it can cause extreme fatigue.

 

Multiple Sclerosis

MS damages white matter in the brain, in that the central nervous system controls most of the bodies functioning. It most commonly mimics bipolar disorder.

 

Neurosyphyilis

If syphilis (an STD) reaches the brain, it can cause dementia and other psychiatric disturbances.

 

Lyme Disease

This is a serious bacterial infection that in late stages, affects the neurology of the brain causing, depression, psychosis and bipolar-like mood swings.

 

Lupus

Lupus is an autoimmune (the body attacking itself)| disease which can affect the central nervous system functioning.

 

Co-morbid Disorders(3)

Most (95%) of the respondents with BPD in the National Comorbidity Survey met criteria for 3 or more lifetime psychiatric disorders(4)

 

Anxiety

Anxiety is often diagnosed with bipolar disorder and it can have devastating effects on treatment and diagnosis. There can be social impairment and the risk of suicide is much higher.(7)

 

Substance abuse disorder

Up to 50% of those diagnosed with bipolar disorder have abused substances in their life. They are often self medicating(8) but some of the symptoms of substance use disorder are the same as bipolar disorder, such as poor impulse control and poor judgement.

 

ADHD

21.2% of those diagnosed with ADHD also meet the criteria for bipolar disorder.

One study found that the symptoms of elation, grandiosity, flight of ideas/racing thoughts, less need for sleep, and hypersexuality were best for distinguishing between ADHD and bipolar disorder in a sample of prepubertal and adolescent youth. However, this same study found that the symptoms of irritability, hyperactivity, accelerated speech, and distractibility were all common in both bipolar disorder and ADHD, and were therefore not as useful for making good differential diagnoses.”

 

Cluster B personality disorders

Because of their overlapping phenomenology and mutually chronic, persistent nature, distinctions between bipolar disorder and cluster B personality disorders remain a source of unresolved clinical controversy. The extent to which comorbid personality disorders impact course and outcome for bipolar patients also has received little systematic study.”(10)

Borderline personality disorder is often misdiagnosed or comorbid with bipolar disorder.

 

Cardiovascular disease

There is a link between the heart and mind and bipolar patients are more likely to die of cardiovascular disease than people that are not mentally interesting. It is frequently undiagnosed and treated.(11) Those will bipolar disorder should get regular physicals and have their hearts checked more than those without bipolar disorder. (EKG, echo, stress test, and so on)

 

Type 2 diabetes mellutis and other endocrin disorders

Because their bodies cannot regulate blood sugar and glucose, so the high’s and low’s in blood sugar can cause irritability, fatigue, and other symptoms associated with depression or bipolar disorder.

 

Migraines

47% of people that have migraines are clinically depressed(12). Bipolar disorder and migraines is, in fact, a subtype of bipolar disorder itself.

 

Eating disorders

Studies show that there is an associated between subthreshold bipolar disorder and eating disorders, particularly in adolescents, and between hypomania and eating disorders, especially in binge eating disorders, which is more likely to be an adult. Clinical studies show that many with bipolar disorder overlap with eating disorders. There are many parallel’s between bipolar disorder and eating disorders, such as: eating dysregulation, mood dysregulation, impulsivity and compulsivity, craving for activity or exercise.(13)

* I personally suffered from an eating disorder for 8 years: ED-NOS and my moods were most turbulent through those times.

 

PTSD

11% to 39% of those with bipolar also qualify for the diagnosis of Post Traumatic Stress Disorder.(14)

Many with bipolar disorder have had traumatic experiences in life, for example, taking a serious risk during a manic episode.

 

Before a diagnosis is made, all other conditions must be ruled out. On average, it takes five years to get a correct bipolar diagnosis.(5)

 

  1. http://medical-dictionary.thefreedictionary.com/differential+diagnosis

  2. http://emedicine.medscape.com/article/286342-differential

  3. http://www.psychiatrictimes.com/image/image_gallery?img_id=1391585&t=1237832000655

  4. http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=2516

  5. http://bipolar.about.com/cs/menu_diagnosis/a/diag_physcond.htm

  6. http://health.gather.com/viewArticle.action?articleId=281474978229499

  7. http://www.ncbi.nlm.nih.gov/pubmed/16426110

  8. http://www.medscape.com/viewarticle/515954

  9. http://www.medscape.org/viewarticle/549973

  10. http://www.ncbi.nlm.nih.gov/pubmed/15766300

  11. http://www.ncbi.nlm.nih.gov/pubmed/19794361

  12. http://headaches.about.com/od/comorbidconditions/a/BipolarMx.htm

  13. http://www.ncbi.nlm.nih.gov/pubmed/15935230

  14. http://ptsd.about.com/od/relatedconditions/a/PTSDBipolarDisorder.htm

 

The Fisher Wallace Unit: Worth it?

ImageThe Fisher Wallace Unit.

 

I personally haven’t tried this thing out, because I can’t afford it, and I haven’t done the research. It almost seems too good to be true, so I’ve gone investigating on if this device helps or not. It is said to be used for anxiety, insomnia, and depression.

It is supposed to work relatively fast, they claim it will “relieve your symptoms within 60 days of receipt” or you get a refund(1).

 

How does it work?

It is portable and is considered “cranial electrotherapy stimulation” (CES). The name does sound kind of scary. It is delivers pulses to stimulate the brains production of serotonin and GABA(3) and beta-endorphins, three things that basically make you feel better. (2) It is FDA cleared and appears to have no side effects and has been in use for over 20 years. It is mainly used in depression, anxiety and insomnia but there are reports that it works well for alcohol withdrawal as well. No placebo effect was found(4).

 

It is used twice a day for 20 minutes. It delivers a mild current that is 1/1000th of the jolt given for ECT, so you’re sort of performing ECT on yourself. Let’s go on.. there is no memory loss. One in 500 people said they had a headache after using the CES. If the electrodes aren’t wet enough before being used, there can be irritation because of this. Some people say they feel nothing at all, others say they feel a slight tingling where the electrodes are placed.

 

Cranial Electrotherapy StatisticsImage(5)

 “It is concluded tht CES is a clinically significant addition to the treatment regimen for this patient population.”

 Is this too good to be true?

  1. The purchase price of the device will be refunded, minus a $69.95 processing fee to cover the costs of used disposables (sponges, headband, carry case) and device testing and processing. Shipping charges and the purchase of extra accessories (such as extra sponges) will not be reimbursed.” http://www.fisherwallace.com/cranial-stimulator-refund-policy

  2. http://www.fisherwallace.com/how-cranial-electrotherapy-stimulation-works

  3. GABA: A neurotransmitter that slows down the activity of nerve cells in the brain.

  4. http://www.ncbi.nlm.nih.gov/pubmed/3521373

  5. http://www.fisherwallace.com/uploads/Ray_Smith_CES_Monograph.pdf

Does semen help with depression in women?

Image

Well, sure, temporarily for the person receiving it. It feels good and it releases endorphins, plus it burns off calories. But what does it do to the recipient? Or the giver? Let’s taking a sexy scientific approach. And we’ll go on both sides of the fence, those who think it does and those that think it doesn’t.

Range of chemicals in semen ‘promote mental well-being and feelings of affection’, say researchers.”(1)

The State New York University conducted a study using surveying comparing 293 women to their sex life and mental health.

Apparently, semen fluid carries three “ingredients” that fight depression. Women having unprotected sex (you should always use protection!(me)) were less depressed and scored higher on cognitive tests.

Semen contains “spermatozoa” and cortisol, which causes affection and elevates mood. It also includes thyrotropin, another antidepressant, melatonin, which is used for sleep and serotonin itself, the main chemical factor in depression.

However, this isn’t new news. The studies were carried out 10 years ago. It basically compares women using condoms or other barrier methods, and women who are not.(2)

This study is full of holes and extreme caution should be used when interpreting anything from it”. 

The research began when scientists wanted to know if semen had an effect on mood in women, and that the chemicals in semen can be absorbed in the vagina. This research, done by anonymous survey, doesn’t show cause and effect.

The research involved: frequency of sex, number of days since they last had sex, and the type of contraceptive used. They were to fill out a survey on depression as well.

Statistics

  • 87% of the women were sexually active.

  • Women who had sex without condoms had lower depression scores than those who were abstraining.

  • Depression scores between women using condoms and not were very different.

  • Of the women who had never used condoms, 4.5% had attempted suicide, compared to 7.4% in the “sometimes use” group, 28.9% in the “usually use” group and 13.2% in the “always use” group.

* The 2002 study did not involve oral sex, only vaginal.

Sorry guys…

There just isn’t enough information to add up and conclude this study. It’s over 10 years old and there aren’t enough factors to make great statistics, or to prove that this is true. Women not using condoms may have poor impulse control, for example(3). Even if it does help with depression, you’d need a lot of semen to help, it’s definitely no cure, but hey, do what you’ve gotta do!

  1. http://www.dailymail.co.uk/health/article-2190863/Semen-good-womens-health-helps-fight-depression.html

  2. http://www.nhs.uk/news/2012/08august/Pages/semen-oral-sex-helps-women-fight-depression-claim.aspx

  3. http://www.alternet.org/gender/sorry-guys-just-because-one-study-claims-semen-cures-womens-depression-doesnt-mean-its-true

Severe Side Effects Part 1 – Diabetes Insipidus

Sever and Rare Side Effects Part 1 – Diabetes Insipidus

Diabetes insipidus has nothing to do with blood sugar. It is sometimes called “water diabetes”. You’re either born with it, or you get it from taking lithium. There is a 1/100,000 chance of getting this disease.

 

Well, I fucking got it.

 

I took lithium for eight years, it helped me incredibly. I went for a routine physical and they found protein in my urine. Further testing and an endocrinologist confirmed that it was, infact, diabetes insipidus. They were testing me for type 2 diabetes because of unexplained weight gain. I went from 120lbs to 160. I’m now in the 140’s, at the 51st percentile for someone my height, build and age.

 

They immediately told me to cold turkey discontinue the lithium. Lithium doesn’t necessarily have withdrawal or discontinuation symptoms, but it still sucks, because that was my main mood stabilizer. It was the only one that worked very well, and it was after my kidneys.

 

They suspected diabetes of some sort because diabetes means “thirst”. I could hardly go five minutes without sipping on something, and I never drink caffeinated beverages. Usually just water, juice, or light coloured pop. My endocrinologist fucked up on the type of diabetes I had, and got mad at me for not monitoring my blood sugar. Then he actually read my file, and gave me a blood work requisition form and told me to come back in 3 months, don’t take Lithium.

 

After 2 months, the symptoms were just as bad, so I called to move my appointment up, and in the end, fired the endocrinologist. I went to my GP for a referral to a kidney doctor, rather than a hormone doctor, and he told me “No, I referred you to an endocrinologist” and literally slammed the door in my face. He was in one of his “moods”. So I fired him, too, and got a new doctor who is fantastic.

 

I was diagnosed at the end of September and I’m taking a diuretic, Apo-Hydro, which means liquids are getting processed by my kidneys, and I’m not peeing out all the nutrients I’m taking in. Sounds kind of weird, that a diuetic has an opposite effect on someone with DI. After only a week, I’m seeing results. I’m not so thirsty, I’m not as dehydrated and I’m not going to the bathroom (literally) 20 times a day.

 

What causes diabetes insipidus?

Because this is a bipolar blog, I’m only going to cover the nephrogenic class of DI, because that is what lithium can rarely cause.

It is a defect in the kidneys that reabsorbs water back into the bloodstream.(1) It can be cause by genetics or certain medications, lithium being the big one.

 

Symptoms

The initial symptoms are the same as diabetes mellutis and that is why it is called “diabetes”. They are two completely different disorders, though. DI effects the kidneys, while diabetes mellutis effects the pancreas.

The main symptoms are: Excessive thirst (check!), which can be intense and uncontrollable (check!), craving ice water (check!) and excessive urine volume, as well as urinating way too much.

A urinalysis is used to diagnose this type of DI.

 

Depending on the severity of the condition, urine output can range from 2.6 quarts (about 2.5 liters) a day if you have mild diabetes insipidus to 16 quarts (about 15 liters) a day if the condition is severe and if you’re taking in a lot of fluids. In comparison, the average urine output for a healthy adult is in the range of 1.6 to 2.6 quarts (about 1.5 to 2.5 liters) a day.”(3)

 

Treatment

Stopping lithium has been said to control the diabetes insipidus and it takes a while. The disease will reverse itself and the kidneys will function normally again. Sometimes, after long term use of lithium, it becomes permanent. I just thought that lithium made you thirsty, so I drank a lot of water, and went to the bathrom a lot. Diuretics are the main medications used to treat nephrogenic DI.

 

Prognosis

If treated, diabetes insipidus does not cause severe problems or shorten your life.(2) If not treated, you can end up dehydrated or have an electrolyte imbalance.

 

Quick Facts(4)

  • Diabetes insipidus is not related to diabetes mellitus (type 1 and type 2 diabetes).

  • Diabetes insipidus is caused by problems related to the hormone antidiuretic hormone (ADH) or its receptor and causes frequent urination.

  • There are four types of diabetes insipidus; 1) central diabetes insipidus, 2) nephrogenic diabetes insipidus, 3) dipsogenic diabetes insipidus, and 4)gestational diabetes insipidus.

  • The most common symptom of diabetes insipidus is frequent urination.

  • The diagnosis for diabetes insipidus is based on a series of tests (for example,urinalysisand fluid deprivation test).

  • The treatment for diabetes insipidus depends on the type of diabetes insipidus.

  • Diabetes can lead to chronic kidney disease.

  • Diabetes is the most common cause ofkidney failurein the US.

So, in the end, I’m hoping that it will clear up over the next year or so, and I won’t have to take diueretics for the rest of my life!

 

  1. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001415/

  2. http://www.nlm.nih.gov/medlineplus/ency/article/000377.htm

  3. http://www.mayoclinic.com/health/diabetes-insipidus/DS00799/DSECTION=symptoms

  4. http://www.medicinenet.com/diabetes_insipidus/article.htm

ECT vs. TMS

TMS vs. ECT

ECT (electroconvulsive therapy, it used to be called “shock therapy”) has been around for a long time. For unknown reasons, it helps with depression and bipolar disorder. I wrote an article about my personal experience with ECT earlier in the month. Some people still think it’s a brutal, gruesome treatment but it really isn’t. My ECT doctor said it was 75-85% effective, and it helped me tremendously.

 Image

What is ECT?

During electroconvulsive therapy, a patient is anesthetized and a small amount of electrical current is used to stimulate the brain. This produces a modified seizure, which, in turn, changes the activity of the brain. Some of these changes are similar to those seen with certain antidepressant medications in the way they relieve symptoms. The medications used for anesthesia prevent injury and patients feel no discomfort during the procedure.”(4)

 

TMS stands for “transcranial magnetic stimulation”(2) and works under the impression that the brain can be stimulated by magnets, something becoming more common. Magnetic fields easily pass through the skull and into the brain, but to effect the neurons inside the head, there must be a lot of magnetic energy flowing. TMS machines send a pulse through every three seconds and were made for diagnostic testing. It is non-invasive with very few side effects and capable of modifying the brain.

 

The magnetic field in TMS works by magnetic fields being produced by a passing current in a hand held coil(2). The shape determines properties and size of the field. The coil is held at the scalp, and no contact is necessary, unlike ECT, when the electrodes touch your scalp.

 

TMS has less side effects. There has been reported that there is no memory loss and no seizure. It was invented in the late 1980’s, while ECT has been used since the 1930’s(3). ECT is 70% effective.(5) Both procedures cause headaches. TMS takes more time, up to 5 times a week for an hour. A doctor, a nurse and an anesthesiologist are required for ECT and the patient wakes up confused and often disoriented. TMS doesn’t have these side effects, you get up and walk out.

 

Image

What exactly is TMS?

Transcranial magnetic stimulation (TMS) is a non-invasive treatment for adults with major depression that uses magnetic stimulation of the brain to help modulate mood. The procedure was approved by the Food and Drug Administration in October 2008 after more than ten years of clinical investigation in patients who failed to achieve satisfactory improvement from depression from one course of pharmacotherapy (medication). For this reason, transcranial magnetic stimulation (TMS) is particularly helpful for people with depression who have not experienced significant relief from antidepressant medications or have difficulty with side effects.”(4)

 

ECT is a quicker fix than TMS. It takes 7-10 sessions, on average, for ECT which is only a couple of weeks. TMS is 5 days a week, for several weeks. It is not known exactly how ECT works. ECT has a durability of six months, on average. Generally, a patient is taken off of meds before ECT, while during TMS they can stay on the medications and get a “boost” from them. In many cases, the patient still has to take medication after, but not as much, and it’s more effective.

 

One of many theories of ECT efficacy is that the electric field releases a torrent of neurotransmitters.”

 

As for price, TMS runs at about $10,000, while ECT is about $24,000 because of the team needed to administer the treatment. ECT is still considered the best and quickest acting therapy for treatment resistant depression.

 

  1. http://www.ncbi.nlm.nih.gov/pubmed/18580559

  2. http://www.musc.edu/tmsmirror/intro/layintro.html

  3. http://www.elata.org/tms-faq.shtml#_How_does_TMS_1

  4. http://www.mclean.harvard.edu/patient/adult/ect.php

  5. http://truth-out.org/news/item/11833-tms-breakthrough-new-hope-for-treating-severe-depression-with-few-side-effects

 

Book Review: More Now Again (Elizabeth Wurtzel)

I am not a huge Wurtzel fan. In her first book, Prozac Nation, the one that kicked off her career, I wasn’t thrilled about it and it was a long read for me. She came off as selfish, irresponsible and attention seeking. I got a “fuck everybody else, the only person in the universe is me” vibe.

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Now, with More, Now, Again, she straight up says the book is about her and drug use. Not people, not friends. She blatantly uses her friends to send her drugs, and after being arrested, actually asks a police officer if they can stop at an ATM so she can get herself out of jail for shoplifting.

The book describes her drug use. Again and again. Not caring if her friends see her snorting Ritalin. Moving from place to place. Tweaking (tweezing the hair from her legs and getting infections) She comes off as selfish and narcissistic. She lacks emotion and everything she does is for herself. She expects the world to bow down to her.

She tries to romanticize drug use, starting on the first page of the book. She obviously has problems deeper than atypical depression (something she was proud of in her first book, because it’s “better” than normal depression) She gets herself into bad situations, the entire book is Me! Me! Me! She eventually goes to rehab. She can’t manage real-world grown-up things like her finances. She hires a CPA to do that for her. I was appalled when she missed a great opportunity with Coach and tries not to take the blame for herself. It’s always somebody elses fault.

The book is decently written, it doesn’t really have a “tone” to it. It is written with blatant honesty, at least, she knows what she has done wrong, but doesn’t do much to correct it. Honestly, I liked the memoir, but got sick of it near the end and if I pick it up to read again, I can only go for a few pages before I get bored. I am not a big Wurtzel fan. She needs not to be coddled, she needs a tough-love approach. She lies to get what she wants, and admits it. Sending cocaine in the mail?! That’s absurd!

I won’t be reading any of her future books. This book caused me to rage a little bit. I felt pity for her in Prozac Nation, but she’s really playing the “poor me” card. She was more relate-able in Prozac Nation, and I give that 2.5 stars. This book barely gets 2. People either love her, or hate her, I noticed, from her book on Amazon. I fall in the latter category. This book is an okay read, it’s long and has boring, repetitive parts, but it is interesting, I’ll give it that much.