Thursday, March 6, 2014

Depression Treatment: Electroconvulsive Therapy (ECT) Or Transcranial Magnetic Therapy (TMS)?


Electroconvulsive Therapy. Two words that make up one complete and disturbingly descriptive sentence.

In a nutshell, ECT works by inducing a physical seizure. But, when compared to the emotional/Life Seizure induced by deep depression, ECT may be preferable.

ECT has had some remarkable successes but, like any other therapy, electroconvulsive therapy is not for everyone. And, ECT side effects are also a consideration because they can be disturbing.

Keeping in mind that ECT and TMS treatments use some form of electricity to stimulate the brain, there are very important differences between the two:

- Electroconvulsive Therapy (ECT), also known as electroshock therapy, uses an electric shock to induce a seizure. TMS uses a magnetic field to induce a much smaller electric current in a specific part of the brain without causing seizure or loss of consciousness.

- In many cases, ECT has been very effective in treating severe depression. TMS is not so powerful but, concurrent treatments to TMS such as neuro-feedback and/or hypnosis may actually boost the healing power of TMS. For now, TMS is used to treat milder depression, and it can only be prescribed for patients who have failed to benefit from one, but not two or more, antidepressant treatments. This treatment restriction may change in the future however, a depression sufferer may still benefit from appropriately applied complimentary healing methods such as hypnotherapy or biofeedback.

- TMS is much safer than ECT. Unlike ECT, TMS does not require sedation and is administered on an outpatient basis. TMS patients can drive to and from treatments on their own.

- Electroshock therapy always causes temporary confusion. And it often causes temporary--but sometimes very disturbing--memory problems. Plus, it can have significant effects on the cardiovascular system which can be an issue for some patients. TMS causes none of these problems. Another way of seeing this is that TMS is virtually free of side effects.

A question that many of my patients have needed to answer before seeking help is, are they truly depressed or just going through a normal life sadness event?

For instance, someone once contacted me and, after telling me that they had just lost a loved one, they then asked: "Do I need anti-depressant therapy?"

They asked about antidepressant medication/psychological treatment because their feelings of sadness and loss were overwhelming and seemed to be out of control. And, they did indeed score "yes" on many depression symptoms (listed below.)

However, after speaking with them some more, I determined they did not fit a "depressed" diagnosis but, their levels of pain were such that they did need some support.

Wondering which might be best for them, I asked them how they felt about hypnosis and receiving a positive answer, I then invited them in for a hypnosis session to help them constructively deal with a very difficult issue.

NLP (neuro-linguistic programming) was also a good match for my patient and so I used some very effective NLP methods to help them to be able to better make it through some very difficult days.

Losing a loved one hurts beyond words and it is understandable to want to fade away or die to avoid the pain however, most people truly do not want to die; they just don't have the tools to keep moving on until the pain eventually fades.

With the above in mind, and, after over 20 years in the psychiatry field, it is my firm belief that if proven, complimentary methods such as neuro-feedback, NLP and hypnosis were employed at the onset of truly painful life events, then costly, disabling depression could be avoided.

In other words, those who have suffered terrible losses could be saved a lot of terrible emotional and financial cost such as alcoholism, unemployment and more.

How can someone avoid the emotional/financial bankrupting costs of depression? They can learn how to recognize if they are depressed. This goes for you tough guys (and gals) out there who think you don't need treatment (also known as healing from painful events.)

If you are in pain and you want to feel better and you are curious, check out the possible signs and symptoms of depression listed below.

Note that in general, the below potential depression symptoms have lasted at least two weeks and have filled a significant part of your days.

- Persistent sad mood with feelings of "I can't take it anymore - I just want to die."

- No patience. Not even for little things.

- Little or no interest in things that used to excite you, such as sex.

- Sleep problems. You know if you have them. Waking up often; trouble going back to sleep; racing heart when you wake up; huge heaviness in your stomach when you wake, etc.

- Eating disturbances; either suddenly becoming too much or too little.

- Inability to concentrate and/or sit quietly.

- Your thinking is "different" although you're not sure exactly how. Your body doesn't seem your own.

- Can't make up your mind; even about little things such as what to eat.

- No energy even after sleeping all night - even small tasks are really difficult and require a lot of effort.

- A deep feeling that you are worthless and/or guilty of being deeply inadequate.

- Memory problems that are not normal.

- Intrusive, uninvited thoughts of wanting to die... and agreeing with them.

- Making serious plans on how you are going to "resign from life."

Something that is important to remember is that even if one of the above signs and symptoms of depression is overwhelming, disabling or otherwise having a significant negative impact on your life, then get some help.

Depression can be overcome. There is a rainbow to your personal storm. I'm glad that you took time to read this article. Thank you.

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