Please, tune in to Dr. Oz show next Wednesday, February 8, 2012, as he talks about TMS Therapy and its use in the treatment for depression. He might even have a demonstration of the actual TMS Therapy procedure.
October is National Depression Awareness Month! Approximately 14.8 million American adults suffer from (clinical) Depression in any given year.
Persistent depression can interfere with a person’s health and social well-being, affecting normal day-to-day activities. The first step to recovery is recognizing the causes and symptoms of depression. Although overcoming depression takes time, it can be possible by making positive choices for yourself and drawing on support from the people around you.
The following are some tips to help you cope with depression:
Know when to get help. If symptoms of depression persist or become worse, do not hesitate to get professional help.
No! TMS Therapy uses a much more refined and safer way to stimulate brain regions that are affected by depression.
“Shock Therapy,” or ECT, uses the application of electricity on the scalp, with the goal of inducing a seizure throughout the brain and thus “rebooting” all the brain circuits. Side effects have somewhat improved over the years, but there are still some cognitive side effects, with memory loss, as well as the risk of anesthesia as a patient needs to be under anesthesia and their muscles paralyzed. There is some recovery time (after each session) and the need to have a driver to drive the patient home. Because of its side effects, ECT is considered a "last resort" treatment. It does carry a lot of "stigma," but it can be life-saving in emergency situations.
In TMS Therapy, the procedure does not require sedation or anesthesia. Patients are awake and alert and upon completion of the session, about 37 minutes later, they can drive themselves back to work or school. It involves the application of a magnetic pulse to a specific brain region, called the prefrontal cortex or PFC, to gently stimulate brain neurons. It is like a “soft reboot” of specific brain circuits, without any loss of memory or other serious side effects.
TMS Therapy is not a “last resort” treatment like “shock therapy,” and it has actually been approved by the FDA and assigned by the APA Treatment Guidelines for Depression as a 2nd line therapy (after failure of at least 1 antidepressant given at high enough dose, for long enough period).
For more information on TMS Therapy, please contact us at Victoria TMS Center. You can visit us at www.vtmsc.com or call us at (361) 582-5678.
Dr. Bouras has been invited to speak on "Aging and Depression." This is an educational seminar offered by Senior Care Solutions, to be held on Tuesday, April 26, 2011, 11am-1pm, at First United Methodist Church.
To RSVP, please call Kathy Frels, RN (361) 576-5553 by 4/21.
See you there.
I came across this Flyer on Stigma and Discrimination on Mental Health, from the Canadian Mental Health Association, about how the "stigma" for mental health actually becomes "discrimination" against mental health. This reminds me of the efforts of organization in the USA, like Mental Health America and NAMI, who lead every day in the effort of "de-stigmatization" of mental illness. We need to educate people that mental illnesses are brain illness, and with the proper diagnosis and treatment, people can live full, productive lives.
Do you have any ideas on how to end this discrimination that prevents people from getting much needed help?
When somebody asks us about our health, we usually think only of our "physical" health. But, everyone should also be thinking of our "mental" health which many times directly influences our quality of life (being happy).
We can think of "health" as the opposite of "illness." Do I have a high or low blood pressure, high or low blood sugars, high or "normal" cholesterol,…you get the idea. I might or might not have symptoms, but if I were to be examined by a doctor, and the measurements (blood pressure reading, lab results) suggest that I am not "healthy," I would want to manage my illness to become "healthy" again. I might be counseled on what to eat and what not to eat, encouraged to exercise, and I might even be placed on some medications.
While everyone can see themselves in such a situation, no one wants to admit that they might not be "mentally" healthy. There is still so much stigma attached to mental illness, that some people get offended if one suggests that they or someone in their family might suffer from a psychiatric condition. This could be because many people equate being "mentally" unhealthy with being "crazy" or feel that it is completely in their control not to have any psychiatric symptoms. This could not be further from the truth.
Even though there was a (sad) time when people with psychiatric illnesses were placed in "asylums," a lot has changed since then. It is well accepted in the medical community that psychiatric illnesses are brain illnesses, much like diabetes is an illness of the pancreas and hypertension is an illness of the cardiovascular system. The 90's was called "The Decade of the Brain." Through technological advances (EEG, MRI, fMRI, PET scan, TMS, etc.), we have been able to map the brain, view its structures, understand how its different neuronal circuits interact, and how differences exist in different psychiatric conditions. We can measure neurotransmitter levels in the cerebrospinal fluid (CSF), the fluid that bathes our brains, and even look at our DNA to individualize our treatment. We also know that psychiatric (brain) illnesses are deteriorating illnesses, damaging the brain if left untreated. By no means, do I suggest that we have learned everything there is to know about the brain, but we know enough to help people today more than ever.
One might ask why we do not have any type of measurement or marker that suggests a brain illness, like we have with measuring blood sugars in diabetes. That is a fair question. But before I talk about this, let me just briefly talk about the common flu and its symptoms. Most of us have had the flu at one time or another. People with the flu may feel miserable, tired, having headaches and body aches, and not feeling like doing anything. The doctor will examine you by asking you about those symptoms, rule out other more serious conditions and even differentiate a flu (viral) from a bacterial infection (that needs antibiotics) without getting any lab tests.
Brain (psychiatric) illnesses also present with symptoms. The brain affects how we think, feel, behave, and perceive the world. The brain is also the "command center" of our whole body. When certain brain circuits do not function properly, they can produce different symptoms, affecting cognition (being distracted), emotions (feeling anxious, depressed), perceptions (thinking that people do not like me, people are watching me), and behaviors (sleeping or eating too much or too little). Looking at the symptom patterns, we can usually arrive into a diagnosis. We might order tests to "rule out" other conditions, but we do not necessarily need to order a "diagnostic" test to know that someone suffers from depression, for example. Even if tests are available, we have to look at the risk/benefit ratio of getting those tests done. Checking the serotonin level (a brain neurotransmitter) at the CSF to support the diagnosis of depression will not change our treatment and it actually puts the patient at unnecessary risk by having to do a lumbar puncture (LP) or spinal tap, to access the CSF. Likewise, ordering a functional MRI (fMRI) on everyone with depression will add an unnecessary cost burden to the patient.
Large epidemiological studies suggest that about 20% of US adults have a diagnosable psychiatric (brain) condition at any given year. For the majority of these individuals, their symptoms might be acute and not very severe. Only 12% of those adults (or 2.5% of the total population) have a more severe and chronic psychiatric condition, and for 20% of those individuals (or 0.5% of the population) the illness is so debilitating that it usually leads to disability. These are the individuals with Schizophrenia, but also Bipolar illness, and severe forms of Depression, Panic, and Obsessive-Compulsive disorder.
We know that there is a large genetic component with many psychiatric conditions running in families, just like hypertension and diabetes. Not everyone with a genetic predisposition will develop a psychiatric illness and not everyone will have a predisposition. Expression of the predisposition usually happens under times of stress (mental duress). Persons with psychiatric (brain) conditions are no more responsible for their illness than persons with pancreatic conditions (diabetes).
We treat psychiatric (brain) conditions with counseling about "diet and exercise," education about their illness (like you would educate someone about diabetes), psychotherapy (because brain conditions affect how we feel, think, perceive, etc.), medications as well as stimulation therapies like transcranial magnetic stimulation (TMS Therapy), vagus nerve stimulation (VNS), and electro-convulsive therapy (ECT) when warranted.
We can think of our "mental health" as how well we cope with stress, how satisfied we are with our relationships, with our jobs, and with our life. When we start having persistent problems with our relationships, our job performance, or neglecting our societal roles, that suggest that our brain circuits do not function as well, and we thus may have a psychiatric (brain) illness that needs to be evaluated and managed. Getting timely help not only avoids unnecessary suffering from delayed treatment, but it also helps protect the brain and its circuits from further deterioration and damage.
So, the next time you think about your health, think about both your "mental and physical" health.
Victoria TMS Center will have a booth at this year's Health-a-rama, at the mall, on Saturday, October 2, 2010. We will have information on Transcranial Magnetic Stimulation, the new, proven, cutting-edge technology for the treatment of depression. Come to get info and sign up to win some prizes. See you there!
Dr. Bouras will be talking about "Living with Depression," as part of the Citizens Medical Center Healthwise Program on Thursday, September 16th, 2010, at 5:30pm. The event is free to the public and it will take place at Citizens Medical Center Central Classroom. For more information or to reserve a seat, please call (361) 578-WISE (that's 578-9473).
NAMI Victoria started offering free Family to Family Education Programs last year. This program is taught by trained family members of patients with psychiatric illnesses, geared towards family members of other patients. They offer information, insight, understanding and empowerment to those families.
This year's class starts on Tuesday 8/31/10. It is held every Tuesday, 6:30pm – 9:00pm, for 12 weeks, at St. Francis Episcopal church on Miori Lane. To register, please call Bruce 395-6611, Jessica 676-9730, or Patsy 578-3935.
You can download their flyer here:
Flyer for Family to Family Program.
Dr. Bouras was recently featured as one of the guests of Steve Broussard of KATU, Community Crossroads program, talking about depression and TMS therapy.
This is part 2 of that interview:
