Can holding a magnet against your head help defeat depression?
Source: dailymail.co.uk
Former GP Sue Mildred suffered from crippling depression and anxiety for 20 years.
On two occasions it was so severe that she ended up in hospital, and for 15 years she was unable to work.
Sue, 51, has tried antidepressants, talking therapies and, out of desperation, even ECT (electro-convulsive therapy), where an electric current is passed through the brain.
This did provide brief relief, but she started to develop memory problems, so she stopped it.
Eventually, Sue became resigned to the idea that her condition would never improve.
Yet two years on her mood is lighter and she is back at work — thanks, she believes, to a new treatment called transcranial magnetic stimulation or rTMS.
This involves having an electromagnetic field applied to the head to stimulate specific areas.
Brain scans suggest transcranial magnetic stimulation can cause changes in the circuitry of the brain.
In depression, doctors target the prefrontal cortex, the region of the brain involved in decision making, mood and emotional responses.
This month, U.S. researchers reported that the treatment triggered significant improvements in patients with severe depression who had failed to respond to other treatments, including antidepressants.
At the end of the year-long study of more than 200 patients, 68 per cent reported a reduction in symptoms, while 45 per cent were in complete remission.
And, in July, researchers at Harvard Medical School published a study testing the treatment against a placebo that showed it had ‘immediate’ effects on mood in people with depression.
It is already used to treat conditions including epilepsy and Parkinson’s.
‘I read up on it, and after looking at the trials carried out over the years, felt comfortable trying it,’ says Sue.
Searching online, she found the London Psychiatry Centre, a private clinic that offers rTMS. She had two courses, each one consisting of five sessions a week for six to eight weeks.
During each 30-minute treatment, Sue sat in a chair while a magnetic coil was held against her head. Up to 3,000 magnetic pulses were applied to her brain for a few seconds at a time, followed by a break of a few seconds.
The effects have been gradual but life-changing.
‘It’s not like there’s one day when you suddenly feel well,’ she says.
‘I just found that I started to have hope and confidence.’
Within three months of finishing the course, Sue was able to go back to her job in medicine, and is now working with elderly patients with psychiatric problems.
‘There’s no comparison with what I was like before,’ says Sue.
‘I was very, very scared of doing anything because I always felt like it would go wrong.
’I had lots of hopeless feelings, and although I never planned it, I had thoughts about suicide.
’I never, ever thought I’d go back to work.
‘I had tried many times, but would get ill again before I could sort everything out.
‘I think it’s pretty miraculous that this has happened.’
The treatment is already available in the U.S. to patients with depression who have not responded to antidepressants or therapy, but here, the National Institute for Health and Care Excellence (NICE) says more research is needed.
But for Sue, who still has two maintenance rTMS sessions every three weeks, the only drawback has been the cost: £400 a session.
‘It’s hard to envisage it being available on the NHS because it’s so expensive; but then if my situation was replicated and more people were able to go back to work, it would actually be financially viable.’
rTMS may have benefits beyond depression. It is now also being tested as a new treatment for the eating disorder anorexia.
One in 150 women will be affected by anorexia at some point and the condition is notoriously difficult to treat.
According to research, at the moment only around 46 per cent of anorexia sufferers make a full recovery.
Typically, patients are treated with a combination of antidepressants and talking therapies.
Now a trial is under way at King’s College London’s Institute of Psychiatry to see if rTMS may help — and initial results are encouraging.
Stephanie, 24, was one of the first to try the new treatment. She has battled anorexia since she was 13, and has since spent several years on a specialised eating disorder unit in a mental health hospital.
Often she was so resistant to eating that she had to be fed through a tube. On several occasions, her weight was so low that she came close to death.
‘There’s this idea that people with eating disorders just need tough love — that they need to snap out of it,’ says Stephanie. ‘But it literally felt impossible for me to eat or to keep food down.’
Stephanie tried antidepressants and psychotherapy, but struggled to fight the illness. Like Sue, she tried ECT but stopped due to the effect on her memory.
Then her uncle, a GP, heard about rTMS. In May last year, still living under section in hospital, Stephanie contacted the Institute of Psychiatry, where researcher Jessica McClelland is running trials of rTMS as a treatment for anorexia.
She was a suitable candidate for the trial and had one 20-minute session every day, five days a week, for four weeks.
‘It’s not painful,’ she says. ‘It just feels like something tapping on your head.’
She was not convinced at first, but as the days and weeks went by, Stephanie began to notice a difference.
‘I started to feel less depressed and more confident that I could get better,’ she says.
‘Although the illness was still there, I felt strong enough to start fighting it.’
She says her anorexic symptoms have reduced markedly. At one point she would be sick after almost every meal, but since having rTMS she’s gone weeks without vomiting.
Stephanie is now out of hospital, and although she’s still underweight, she’s slowly starting to return to a normal life.
‘I now live in a rehabilitation house during the week and independently at weekends,’ she says.
‘Previously, I could only eat with someone sitting next to me and prompting me to make sure I ate the whole meal.
‘Now I eat independently. I don’t necessarily want to do it, but I know it’s what I need to do to continue to get better.’
Jessica McClelland adds: ‘Our hope is that by doing this we can alter the urge to restrict what you eat, and the anxiety around feeling fat or full.’
Over the past two years, she has carried out a trial of 60 people, comparing a single session of rTMS against a placebo treatment.
‘Preliminary results suggest that after one month and at six months there was a broad improvement in the patients’ anorexic symptoms, anxiety and depression and stress levels,’ she says.
‘Although there was no marked weight gain, people reported their weight was steady and that they were thinking differently and feeling more open and willing towards their other treatments.
‘So we don’t think this is a cure — but early evidence suggests rTMS alongside psychotherapy may be very beneficial.’
Stephanie agrees the treatment made her more responsive to psychotherapy.
‘I’m more confident and vocal. If I’m struggling and need help, I can say it — whereas before I would have kept it all inside.
’When I was in hospital, there were so many times when I just wanted the doctors to give up on me, and to allow me to die.
‘Now I’m in a better place, I’m so grateful that they didn’t.’
She hopes to start a nursing course in September and says she’s determined to get back to a weight that will allow her to one day have children.
‘I’m more involved in life,’ she says. ‘I go out with friends and socialise more. I feel brighter.’
Dr Jane Morris, consultant psychiatrist at the Royal Cornhill Hospital in Aberdeen, who specialises in the treatment of eating disorders, says the new research is ‘exciting’, but adds there is not enough evidence to say that rTMS works yet.
‘Certainly, there seem to be some effects on the brain, but whether these will be meaningful and long lasting and without side-effects is far from proven.’
Source: dailymail.co.uk
