When recovery from depression seems hopeless, are there other options? A patient's perspective

By Andy Behrman, Guest Blogger

My experience with electroconvulsive therapy (ECT) began in 1995, when I opted for ECT as a last resort for treating my bipolar disorder. For so many people who were termed medication resistant and suffering with depression or bipolar disorder, ECT was the “last stop” when it came to treatment. But the variety of medications and other treatments now available to patients suffering from depression has expanded dramatically over the last 17 years.

I recently became extremely curious about a treatment for depression called TMS (transcranial magnetic stimulation). I was surprised to discover that even though TMS is a non-invasive outpatient procedure with few side effects, does not require anesthesia, and was approved by the FDA as far back as 2008, it is still very much “under the radar” and is a treatment which many patients are not very familiar.

According to Kira Stein, M.D., psychiatrist and medical director of Los Angeles-based West Coast TMS Institute, “In a recently published multicenter naturalistic study, 58% of patients significantly responded to TMS treatment, with 37% undergoing complete remission."

Today, TMS is primarily being used to treat those of us suffering with depression. The statistics for depression are alarming: 1 in 6 people experience it in their lifetime, which means that more than 50 million Americans are likely to struggle with clinical depression. Unfortunately, of this population, only 1 in 4 people get adequate treatment. One of the biggest concerns is the risk of suicide, as more than 36,000 people in the United States take their lives every year. Untreated depression, which causes disability at work and disrupted family and interpersonal relationships, can also lead to self-medication with drugs and alcohol. Depression has reached epidemic proportions and has become a silent killer.

When I speak to audiences about mental illness, I always encourage people who suffer from depression to seek advice from a mental health professional. Sometimes, getting people to overcome the stigma of suffering from depression is one of the hardest jobs I have to do. It is often the patient who resists seeking help, often because of the stigma, who really ends up at risk. But today, there are more treatment options than when I was ill. Technology is giving doctors more tools, and patients much more hope, for recovery.

Andy Behrman is the author of “Electroboy: A Memoir of Mania,” a personal story about his bipolar disorder, his experience electroconvulsive therapy (ECT), and his recovery from drug and alcohol addiction. Behrman advocates for mental health awareness and suicide prevention. He speaks to college audiences, health care professionals, and local and national mental health support groups working to stop stigma surrounding mental illness.

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Addiction: A Real Disease with Effective Treatments

By Amanda von Horn, Medical Student

Reviewed by Claudia L. Reardon, M.D.

For September's National Recovery Month, let's discuss recovery from alcohol / drug addiction. Odds are that you or someone you know has struggled with addiction, whether it be alcohol, street drugs, or prescription medications. Unfortunately, many believe that those who struggle with addiction are simply weak, lacking morals, or don’t have the desire or will-power to stop using. The fact is that addiction is a chronic brain disease with real physical and psychological symptoms. People may voluntarily use drugs or alcohol initially, but the drugs themselves can change the brain and make it extremely difficult to stop using, even if they have a strong desire to quit. 

This post answers some commonly asked questions about the disease of addiction. Hopefully you will share the information so others understand that with treatment and support, people do recover.

What actually is addiction?

Addiction is a long-term, often relapsing brain disease that results in repetitive and compulsive substance use despite harmful effects or consequences. 

 

Why is it so hard to stop using drugs/alcohol?

With long-term drug/alcohol use, there are significant changes in the “reward” pathways of the brain. These changes can result in needing more and more drugs just to feel normal. Stopping the drug often causes withdrawal, with symptoms such as intense nausea/vomiting, fevers and chills, horrible depression and/or anxiety, and in some cases even life-threatening seizures. 

Why does addiction affect some people more than others?

Addiction can be caused by many factors, and it is hard to predict individuals who are more vulnerable to the disease. A person’s biology and genetics can play a big role; for example, if a parent abuses drugs/alcohol, the child has a higher chance of having the same problem than does a child of parents who don’t use. 

I am struggling with addiction. What kind of treatment is available?

No one treatment is appropriate for everyone. Effective treatment often involves a combination of medication, counseling, behavioral therapy, and 12-step programs such as Alcoholics Anonymous and Narcotics Anonymous. In many cases, a person may need hospitalization to treat the physical symptoms of withdrawal in the early stages of recovery. 

The recovery plan must address not only the patient’s addiction but all aspects of his or her life in order for treatment to be effective long-term. Since relapse is often a part of the recovery process, it is important to identify “triggers” (people, places, or things that set off an alcohol or drug craving for someone in recovery) and how to cope with these triggers without the use of alcohol or drugs. 

If you or someone you know is struggling with addiction, please consult a physician for evaluation. Recovery is possible, and there is no better time to ask for help than now.

For more information on addiction, visit http://psychiatry.org/addiction. 

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