unit 8

What is electroconvulsive shock
therapy (ECT)?

  • a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient

  • n ECT, the patient receives a general anesthetic and a muscle relaxant (to prevent bodily convulsions).

    A psychiatrist then delivers a brief pulse of electrical current, sometimes only to the brain’s right side, which triggers a 30- to 60-second seizure.

    Within 30 minutes, the patient awakens and

    remembers nothing of the treatment or of the preceding hours.

    How effective is ECT?

  • A Journal of the American Medical Association editorial concluded that “the results of ECT in treating severe depression are among the most positive

    treatment effects in all of medicine”

    What is transcranial direct

    current stimulation (tDCS)?

  • In contrast to ECT, which produces a brain seizure with about 800 milliamps of electricity, transcranial direct current stimulation (tDCS) administers a weak 1- to 2-milliamp current to the scalp.

  • how does tDCS work?

  • The psychiatrist applies a weak current to the scalp.

What is repetitive transcranial magnetic stimulation (rTMS)?

  • the application of repeated pulses of magnetic energy to the brain; used to stimulate or suppress

    brain activity

  • Repetitive transcranial magnetic stimulation (rTMS)—is performed on wide-awake patients over several weeks. Repeated pulses surging through a magnetic coil held close to the skull can stimulate or suppress activity in areas of the cortex.

    The rTMS procedure produces no memory loss or other serious side effects, aside from possible headaches.

  • How does rTMS work?

  • The psychiatrist sends a painless magnetic field through the skull

    to the surface of the cortex to alter brain activity.

What is deep-brain stimulation (DBS)?

  • Patients whose depression has resisted both

    drugs and ECT have benefited from an experimental treatment pinpointing a neural hub that bridges the thinking frontal lobes to the limbic system.

  • Since 2003, researcher Helen Mayberg and her colleagues have used DBS to treat some 200 depressed patients via implanted electrodes in the subcallosal cingulate, a brain area that functions as the neural “sadness center.”

Is there a depression switch?

  • By comparing the brains of patients with and without depression, researcher Helen Mayberg identified a brain area (highlighted in red) that appears active in people who are depressed or sad, and whose activity may be calmed by deep-brain stimulation.

How does DBS work?

  • Psychiatrist stimulates electrodes

    implanted in “sadness centers” to calm those areas.

What is psychosurgery?

  • surgery that removes or destroys brain tissue in

    an effort to change behavior

  • Because its effects are irreversible, psychosurgery—surgery that removes or destroys brain tissue—is the most drastic and least-used biomedical intervention

    for changing behavior.

Juliette’s depression is not responding to the normal biomedical treatments. Her therapist has suggested that she try several sessions of _____ to energize her left frontal lobe and reduce her symptoms.

symptoms.

A. psychosurgery

B. rTMS

C. ECT

D. CBT

E. REBT

What is a lobotomy?

  • a psychosurgical procedure once used to calm uncontrollably emotional or violent patients

  • In the 1930s, Portuguese physician Egas Moniz

    developed what would become the best-known psychosurgical operation: the lobotomy.

    Moniz found that cutting the nerves connecting the frontal lobes with the emotion-controlling centers of the inner brain calmed uncontrollably emotional and violent patients.

What is resilience?

  • the personal strength that helps most people cope with stress and recover from adversity

    and even trauma

  • Faced with unforeseen trauma, most adults exhibit resilience. More than 9 in 10 New Yorkers, although stunned and grief-stricken by 9/11, did not have a dysfunctional stress reaction.

    Especially resilient were those who enjoyed

    supportive close relationships and who had not recently experienced other stressful events.

What is posttraumatic growth?

  • positive psychological changes as a result

    of struggling with extremely challenging circumstances and life crises

  • Struggling with challenging crises can even lead to posttraumatic growth.

    For instance, many cancer survivors have reported a greater appreciation for life, more meaningful relationships, increased personal strength, changed priorities, and a richer spiritual life.