Does Brain Stimulation Work Better Than Medication?
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- Опубліковано 2 лип 2019
- This video is about the devices and procedures we use in psychiatry to treat certain illnesses. We call these neuromodulation devices. There are called this because they work by directly stimulating the brain to get their effect. The devices or procedures I’m talking about today are transcranial magnetic stimulation or TMS, electroconvulsive therapy or ECT, vagus nerve stimulation or VNS, neurofeedback and trigeminal nerve stimulation system or eTNS.
Depression and Neuroplasticity video
• What Causes Depression...
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References
Double-Blind, Sham-Controlled, Pilot Study of Trigeminal Nerve Stimulation for Attention-Deficit/Hyperactivity Disorder
McGough, James J. et al. Journal of the American Academy of Child & Adolescent Psychiatry , Volume 58 , Issue 4 , 403 - 411.e3
Carpenter LL et al, Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of acute treatment outcomes in clinical practice. Depress Anxiety 2012;29(7):587-596
Marzbani H, Marateb HR, Mansourian M. Neurofeedback: A Comprehensive Review on System Design, Methodology and Clinical Applications. Basic Clin Neurosci. 2016;7(2):143-158.
Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.
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ECT is totally the brain version of "have you tried turning it off and back on again." But turning a brain off and back on again has risks because brains weren't built for that.
hence a last resort
Save my life 3 times
My daughter did Nuerofeedback and it did wonders for her depression and anxiety. It’s expensive but works!!
Oh that's great to hear! Thanks for sharing.
Theresa Rezac are the results permanent?
I'm a neurotherapist and can attest to this. It absolutely works for depression, there are many studies that confirm this.
DId she take medis before the Neurofeedback? How long did it take i mean how many meetings has she done?
I used to do the BrainPaint nuerofeedback for a long time, but never helped me with any of my issues unfortunately. I guess it’s like everything else, works for some and doesn’t for the other
I’m going on my 6th session for direct neurofeedback for anxiety, depression/dysthymia and I’m happy to say it’s been working for me. I started to see improvements after my 3rd session (some tweaking was needed in the 2nd session) for mood, energy and just overall calmer. I’m fortunate I have work benefits that helped cover a portion of the treatment or I may not have paid past 3 treatments to not see any improvements. So happy to actually feel grateful to have some relief and hopeful for more permanent results paired with talk therapy. For those still struggling, please take my word and don’t lose hope ❤️
How are you today
Im starting TMS next wk. I was planning a final exit so if this helps it will be a miracle. Please 🙏❤️
I've had ECT treatments twice. They never worked on me, I was at the time treatment resistant to almost every medication they've treated me with. Not only was I already triggered by hormonal changes from birth, I slipped into a non-functioning postpartum depression. In out the hospital every month for a year. Was also being treated with antidepressants that caused me to be stuck in suicidal ideation. Several overdoses attempted per year for several years. ECT took my memories permanently, they did too many sessions. My Dr went on vacation before my total sessions he said no more than two more, the doctor in his place did 4 more. It never budged my mood or depression. I also have had TMS but in much less treatments than someone with unipolar depression gets. I'm aware it's not FDA approved for bipolar depression but it was a last resort experimental thing and and it was the miracle treatment to my bipolar depression until I could no longer stomach my latuda and came off of my combination that kept me stable after treatment. In 2009 or 2010 I was offered TMS as a trial and refused because of my horrible experience with ECT, had I gotten it then, I could have changed my life sooner and ended alot of years being consistent in mental he'll. My diagnosis is, bipolar 2 with ultra rapid cycling with mixed episodes, PMD, SAD, anxiety, BPD, PSTD so yes I'm very resistant to many medications and treatments. First unipolar episode onset at 9, first hypomanic episode at 15, stays in a very agonizing depressive state been in consistent treatment since age 19, also diagnosed bipolar 2 at 19, I'm currently 45. It's a miracle I'm still here.
Same. Latuda is poison.
I had the exact same experience. Too much ECT, did nothing for me but TMS worked a treat! Glad you're well, it's a nightmare not many people understand. X
Did you have insomnia?! I’m post pardum and cannot sleep AT ALL. Not even a wink
@@Leesh4you I am postpartum and cannot sleep either. Did you get better. Please help and respond back
Ect saved my life 3 times but very difficult to get in the UK. Seen as last resort but I swear by it. Not sure whether to try tms or esketamine now as currently on 200 sertraline that's not doing anything
Thank you for your work making these videos. For us, people with mental disorders knowing what treatments we can have it is very important and life saving 😊
Thankful for your videos I am bipolar too and I have PTSD and conversion disorder so when people need to know and don't understand my diagnosis I send them your videos everybody's very pleased with your explanations you do a great job of explaining really appreciate what you do for the mental health community
I love that you keep us up-to-date on the latest treatments & information. Thanks so much, Dr Marks!
Yes that's what I want to do. You're welcome.
Fantastic video - as always!! Thank you for your valuable insight! You’re a medical QUEEN
You’re welcome A bell 😊
So good to see...somebody of my color speaking on this and qualified.... we need more doctors like this in our communities to bring awarness
Amen ❤️ ✝️🙏
Thanks for sharing this video, Dr. Marks. It's good to know that there are alternatives offered to regular medications that are usually prescribed. It would be great if you might be able to cover the PONS device offered by Helius corporation. This device was approved in Canada for use for balance/gait issues, however, it has been shown to be incredibly effective for PTSD, trauma, MS patients, stroke patients, speech and balance impairment along with many other benefits. The PONS device is also a neuromodulator and is non-invasive, and appears to be a device that could help so many people who are struggling with issues that affect the brain.
Neurofeedback changed my life. After dealing with general anxiety for many years... I was miserable and just wanted to die. Every day I thought "this is the day I'm going to end my life"... then I didn't have courage to do it, it was exhausting. Therapy and medication didn't work. I can't even explain how much my life has changed. I'm at peace now. I'm finally at ease.
Wonderful! Do you know what equipment was used?
What is the nuerofeedback treatment
Wow this comment is the closest to how I feel. Are you in a better place. I’m scared I will and won’t be here in just the next 6 months!
@@DRJVNAVY I pray for the peace of God to saturate every part of you. You will be here in 6 months. There is hope for you!
I've been having ECT for over a year and a half now for severe treatment resistant depression and it has saved my life. TMS was not effective, although that could have been because my depression continued to advance and I ended up requiring hospitalization. I still take effexor and abilify and I do best if the ECT is every 4 weeks. Thank you for your videos; They are so informative.
did you have chronic fatigue by any chance?
Content on point. Comments en fuego! Gracias por todos information y'all❤
Your videos have helped me so much! I learned when I have psychosis its depression after years of thinking it was mania. Considering TMS
Thank you once again!!! I love your videos and tell others to watch them.
You’re so welcome. Thank you for sharing them.
I underwent 12 sessions of ECT in late 2017 for major depression (9 unilateral ultra brief & 3 bilateral brief pulse). They stopped administering it when I didn’t know my treating doctor. All it did is leave me with 3 months of memory loss which remains & executive function deficit. It is completely barbaric & I would argue that the neurogenisis & increased blood flow seen post treatment is due to brain damage. Never again!
man this really scares the crap out of me!
ECT. scares the crap out of me. Jump starting the brain with a lightning bolt... yea.... no thanks...I hope things improve for you...❤️
Hmm, that sucks cause I'm thinking about doing ect, not sure how it could cause neurogenesis and brain damage at the same time?
So scary.
At least you remember what happened. Hang in there.
I have been wanting to know about neurofeedback for a while and this helps. I have bp2 disorder, and I would just love to be cured of it. But it seems like all there is to do is just learn to manage it. Similar to all mental health problems. I don’t understand why there is so much stigma with mental health. the brain is a powerful organ, and it’s more glamorous than cardiac function for sure. With mental health we blame the victim, like it is some form of moral defect. Dr Marks thank you for these videos. I really enjoy them and feel they have helped me tremendously. Many thanks. Susan
I’m so glad they are Helpful for you Susan. My hope is that the more we talk about mental health the easier it becomes to talk.about it
Dang. Very informative. Thanks for the video!
Thanks for the video. Great information !
You're welcome Yvette.
Dr. Marks, THANK YOU!
Wow, that’s scary. Hope you see better days ahead
I have a VNS to treat my epilepsy and tbh it’s great. I have depression, anxiety, bipolar disorder and borderline personality disorder. Since having my first one implanted in 2015 my epilepsy has gotten a lot better. I went from having seizures a couple times a month to being seizure free for two years next month. Now, with my depression it has made a HUGE improvement because my seizures are triggered by emotional stress. Since I don’t have much emotional stress anymore, I DONT GET SEIZURES!! I love it.
Oh that’s awesome. That’s really great when you get the double bonus of treating both problems.
I am having surgery 8/13/21 for treatment resistant depression.
I never knew there would be somebody that would have the exact illnesses that I do. Thank you for giving me some hope.
That's great!
So exciting
Thank you for your videos. Can you do a video on alcohol and depression / anxiety?
Thank you for your videos. You are very thorough. Can you speak on EMDR?
Great video! I love those little green neurons 😆 they're so cute!
Thank you. 😊 I try to throw them in whenever I can.
Very nice content!
Hi Dr. Marks :) I know you mentioned the vagal nerve stim implant-- any thoughts on the transcutaneous auricular stimulator for anxiety, depression, or even bipolar? Thank you for all you do!
I like other treatment alternatives you give us. I am diagnosed with epilepsy and underwent VNS therapy from 97' to 2007. It didn't help at all and I decided to get my stimulator removed. However, neurofeedback is the best treatment I received along with Chinese medicine.
Did it really? I’ve just recently diagnosed with ADHD. Although I’m coming to terms on the fact that I have autism too. I have CPtsd too but the symptoms of these last two I haven’t told my doctor yet. I’ve heard it’s also a treatment for adhd and autisms as well as ptsd.
I had ECT twice, did nothing but erase my memory. Everyone I''ve spoken to who has had ECT has said it didn't work. I had TMS 4 years ago and have never looked back. A simple painless treatment. Try TMS before ECT.
Ive done neurofeedback it helped anxiety not as much as depression in my experience.
Need fresh video about it, thanks!
I have 7 sessions, currently I have 3, but I have not felt anything different, my memory is fine, I remember everything, the only thing is that the doctor asks me if I have taken any medication such as valium because I am very relaxed during the session, I explained No, the only bad thing is that I felt very tired, a lot of daily muscle pain but I know what the side effects are.
Hi Doctor , I have 2 questions. If you could please answer?
1)Does VNS reduce anxiety for those who don't want to be on medications?
2) Can we figure out as to which side of the brain ( right or left hemisphere) should be stimulated precisely for depression or anxiety during rTMS therapy by doing imaging ? Please explain .
Thank you .
Thank you for introducing me to and explaining for me a therapy that I'd never heard of before. Thank you Dr. Marks for what you're doing for all of us. And have I ever mentioned to you that I think that you have one of the most aesthetically pleasing faces that I've ever seen? 😁
Hi something you said. I’m so glad you’re learning new things from my channel. That’s what I want to happen. It always helps to have something pleasant to look at lol! 😄
Why do I old so much in Student Loans???? When I could have watch your videos!!! Thanks always informative.
LOL 🙂 You're welcome
One psychiatrist who evaluated me suggested that I might need "something more drastic" if medication did not work. I'm guessing he was thinking of ECT. Since my only knowledge of ECT is what "One Flew Over the Cuckoo's Nest" shows, I'm glad to see it isn't really the horror show portrayed in that movie. Thanks, Dr. Marks!
Yes that movie was terrible for the image of ECT. But it still alive and well. And it’s more Advanced than it was back then.
I have had acute phase ECT while inpatient but my memory problems are different. I have lost quite a large volume of memories prior to starting treatment. It is slowly getting better though. The benefits are so worth the negatives.
Thanks dr. Marks.
You're welcome. Thanks for watching. 😊
I was considering ECT in hopes I could lower my medication dose and not have to worry for several years. I need a recharge for my brain.
I really hope the new TMS will be something that will help my OCD. No medication has ever worked neither did ECT (for depression) which was shocking 😕
I hope so too. That's a shame no medication has helped. Maybe some behavior therapy? I talk about exposure therapy in this video. ua-cam.com/video/bYm8kdGmpeA/v-deo.html
Thank so much for this video! I had Deep TMS done for my OCD last year but it didn’t help much. Are there other treatment options for OCD?
I did a video on OCD here ua-cam.com/video/bYm8kdGmpeA/v-deo.html
Dr. Tracey Marks Is laser brain surgery good?
If a person with psychosis hasn't improved after trying three different medications and being in the hospital for 3 weeks would ECT be a treatment to try? Or are there better ways to treat psychosis?
TDCS & TACS? would love you to cover these technologies. TDCS has been approved for at-home depression treatment.
VNS is also used in the treatment of epilepsy.
I was under the impression that the risk of seizure from rTMS was *during* and rTMS session, not after. Are there any documented cases of seizure after treatment? How long after?
Thank you for this video. I have a question. If someone fails one of those treatments are they more likely to fail another type of treatment? For example, if someone failed medication, TMS, and ketamine are they more likely to fail ECT too? Or is that such a different thing that there is no real way to know?
The latter - failing one doesn't predict that you will fail others.
My son developed Neuroleptic induced supersensetivity psychosis. After 1 year of using haldol. Now no medication is working. It makes him psychotic really bad. If we do ECT will it stop sensitivity. Will medication start working again? Or we are just done and there is now way to stop sensitivity
Hi, I was wondering if you could do a video on the difference between mental health issues, and being a hsp (highly sensitive person)? I’m a hsp with mental health issues, and sometimes I find it hard to tell what is just me, and what is my disorders.
Great question. Thanks I’ll work on that
Interesting, never heard of hsp, kinda sounds like me though.
Same
I had ect and I lost all my memories of my children's lives and most of my young life. I had about 15 and did not work at all. I've suffered depression for the last 45 years. I'm going to try tms. I pray it works
Keep faith in God who is most merciful don't lose hope keep it up with all positive
Update, how's the tms?
Please do video for Neiroleptic induced supersensetivity. Please very important
Thank youu.
Any updates on TMS please? I have read recent studies with very high success rates for depression and anxiety and extremely low occurrence of seizures?
Doctor, can you please give opinion or information on tDCS?
Hiya Dr. Tracey.
Does ECT have any beneficial effect on ADHD?
Many thanks.
☺️
What about Insomnia. Is there a treatment for insomnia other than CBTI and Neurofeedback? I tried those with no luck. What are your recommendations?
I've had memory loss and disorientation from my illness, several concussion and many meds I have tried so honestly that's not that much of a down side. I'm getting a little desperate so I am considering ECT.
There 70 likes Dr. Marks. So your last video you asked how me and my family were doing. We’re doing well thank you for asking how was you and your family doing? I think that ECT therapy would be the most effective treatment but you talk about maintenance in the weeks to come is that for life ?
General repair
I am good thank you. Having a busy summer. There may be some people who move to monthly sessions for life but I don’t think that’s the usual. remember The illness is episodic. There are people who can have chronic symptoms that don’t seem to resolve but you can have periods of remission that last months to years.
I’m taking 150mg Efexor and 45mg mirtazapin for anxiety disorder , panic disorder, and social anxiety disorder but I would like to stop taking mirtazapin and keep taking Efexor can you please advise me?
gamma knife for ocd? and focus utra sound ? can you make video for them
ECT will destroy long term memory. It happened to me and I would never recommend it. I had it done in 2017 at the age of 54. I also tried neurofeedback as well with no luck. I am hoping that TMS will work for me.
Is TMS too localized for use in melancholic depression which has subcortical issues
What is your opinión on sgb treatment for depression??
Which of these treatments are generally most covered by health insurance?
Dr Tracy im 28years old and im in the process of saving up for Neurofeedback how do i go about picking a provider and how can I make sure it will be an effective treament ?
Curious she didn't mention tACs. Probably because this can be done at home and bypasses the medical profession.
TMS is best of all treatement as its non invasive compared to ECT which is dangerous and VNS which is also dangerous.
I would love to know more about TMS. I've read some reviews and RCT papers about it but in your practice, how effective is it for treatment-resistant depression?
I don’t do TMS I only know how its regarded in the field. The word on the street is it’s very good, slightly better than medication but not as good as ECT.
I have bipolar disorder and anxiety, TMS made me kinda manic and didn't help my anxiety. I think its good for regular depression though
When I had TMS, it helped tremendously, so much that I loosely in parentheses call it my cure. No it's not a cure. But for someone who've been mostly stuck in and out of rapid cycling bipolar depression for over 15 years, I'm talking about a depression that wouldn't budge. After my TMS treatments my doctor stopped them and asked how much improved did I feel. The first day after last session I felt 60 percent better and that number continue to increase over the next two weeks until I was feeling almost 100 percent better. TMS was my miracle. I have bipolar depression it's very difficult to treat if you have unipolar depression I definitely recommend, especially if it worked for me. ECT has a better success rate and it failed me miserably.
@@DrTraceyMarks I believe my depression is situational and that medications and other modalities won’t change my situation. Can you clarify or describe how meds or other modalities can help someone with situational depression and anxiety?
I feel helpless and hopeless. Having a mood disorder is hell! I haven’t been consistently happy since I was 12.
Try rTMS and cbt
I had ketamine infusions for depression. It’s effected my memory
What if you used a combination of the devices to stimulate light and electric, and vagus nerve stimulation. !! ??
Dr. Mark's are there any studies on ECT for bipolar individuals? That have long term data on the individuals.
Yes there are studies for ECT in bipolar disorder. I don't know about long term data though.
does TMS work for severe anxiety attavks treatement how effective it is
Can you do another video for TMS?
Fisher Wallace device appears to have capitalized on all of these electrical impulse devices. Costly and results are inconclusive.
My daughter’s boyfriend has severe emetophobia, he believes no one can help him and that his case is unique. He refuses to accept that it’s an anxiety disorder. Would any of these work for him?
Do people typically stay on their antidepressants during the ECT treatments? Before and after? Thank you
you need to come off your meds first to zero. stay in psych hospital..then after some weeks as inpatient you may need to go back on meds....but theres also the chance your depression could come back....its harsh bt what are the alternatives
Dear Tracy, what about tDCS?
Hi doc, I was wondering since BPD and bipolar are somewhat similar if DBT would be effective for someone with bipolar? Thanks for your videos they gave me confidence to go to a psychiatrist and now I’m diagnosed with bipolar II
DBT can be applied to BP II, yes
There are skills that center around impulse control, emotion regulation and mindfulness
Yes like Haydn said, it can also help if you have Bipolar d/o if you have some of the issues addressed.
I have bp2 and I have nothing but great things to say about the dbt skills. I have no idea where I would be without them. I’m so convinced of their efficacy I think the entire general population needs to learn this stuff not just those burdened with mental health issues.
Doctor you should have a talk with your viewers about circumstances of mental health recovery where the individual's sufferings come to where they are lucid enough that they take on the guise of visual metaphors to their possessor's eyes, when Pain gets to the point where the imagination begins to See Manifestation of the frayed nerves
I don't understand that concept enough to talk about it. 🙂
@@DrTraceyMarks I've felt my head disappearing, or my head separating from my body, or my head fragmenting and my awareness removing from my body, when depression gets hard enough, its a hallucination that I feel inside
@@markdrost8458 Dissociation?
Hi Tracey. I took Venlafaxine for only 12 days. And it made my OCD worse. Past thoughts would hammer my head, Brain shakes, and Noise sensitivity, all after Venlafaxine. I am now on Prozac 40mg for 2 months. Will Prozac take away the effects Venlafaxine left on my brain? Also, with Prozac, it will faster metabolize Venlafaxine?
I don't know if Prozac will speed up the metabolism of venlafaxine. Probably not since it tends to be an inhibitor of metabolism. I've had success with Prozac taking away the withdrawal effects but its not guaranteed
I took it for Only 12 days. And it gave me brain shakes (while I was on it) brought on by anxiety and thoughts. And intrusive thoughts would hurt my brain all after Venlafaxine. Should I wait it out and tamper of Prozac? Since Prozac won’t help me ?
Omg. I on that
Had a do dr listen to me and test me come to find out autoimmune disease. Cleaned up my gut did hbot methylene blue and peptides.
Wich better this or ect?
would love to hear some feedback from people who have tried tms therapy. I am thinking about doing this myself.
Going under general anesthesia 3 times a week for 6 weeks for ECT sounds like absolute hell. That seems like it would be rough on the liver and kidneys too no?
Hell? You fall asleep then you wake up? I kinda like that feeling of waking up and having no idea of what just happened
The problem with TMS is psychiatrists will only treat patients with mood disorders and that's it. Try to find a psychiatrist that will treat a patient with migraines and has major medication hypersensitivity. They will not treat you at all. Psychiatrists in my opinion are the worst allopathic/osteopathic doctors in the world who only treat mood disorders, have no idea what the long-term term effects of the medication they prescribe, nor understand the relationship of the brain with the rest of the body. For anybody who wants to give me flack, please tell me anytime a psychiatrist actually gave you an exam or did any diagnostic testing before giving medication. They don't and will also take no responsibility from any side-effects from the medication they prescribe.
What about the Fisher Wallace stimulator ?
I already have memory loss on the regular. So would it matter? Also is there a possibility of having seizures afterwards with ECT since it's making seizures happen.
I suppose you could have seizures afterwards if you already have a seizure disorder it may destabilize it. But it doesn’t create epilepsy in people who didn’t have it to begin with.
I had tried TMS it hasn’t helped me now I am thinking about ECT but scared of memory loss.
HI. Can you treat ADHD on teenagers using TMS?
Thanks
I don't think that psychiatrists should prescribe ECT unless they undergo it themselves to see how much damage it can cause . AEven informed consent is a misnomer because no one who has not had it can be informed of the damage it can inflict. Read Peter Breggin's Toxic Psychiatry on this topic.
I was informed that my Father underwent ECT therapy after he passed away. I wanted to understand him and his mental health issues better, as it seems a lot of them are now passed down to me.
As someone with BPD, PTSD and high anxiety, I personally fear ETC therapyand the thought of having it done. Is that normal? Because it sounds like it would be good for fixing all my suicidal thoughts and depression.. yet it scares me, how barbaric it looks to shock our brains into submission this way!
My sister was given ect for bipolar mania she recovered .It helped
Looking into the implants
Great topic to move, will I say.
Thank you
Could you talk about “kindling” in regards to bipolar disorder?
Yes I could. I mentioned it in another video but I don’t remember which one it was. I’ll add this to my list. Thanks
What is the typical dose of Lyrica for anxiety and dose of Zyprexa as an augmentation?
I don’t know the typical dose for Lyrica. I’m not sure if there’s a typical yet it’s not widely used enough to have an established recommended dose. As for Zyprexa it’s also not widely used for anxiety. So you use what works. But if you use it for anxiety we usually start at the lower doses like 2.5 or 5.
I use Lyrica for chronic pain. I'm from nature high on anxiety in general. To my surprise I felt less anxious and more relaxed in social situations in using Lyrica. It's also used for people with general anxiety I understand now. I started with the lowest dose and slowly build it up to the highest, witch is 2 times a day 300 mg. That's very much and in the first months I really had to get along with the side effects. Mostly feeling sleepy and headaches in the morning. I feel much better. Less pain, but emotional also very less an anxious person.
So like Dr. Marks says you have to just try it to see how many mg you need to feel if it helps you. If I were you I should try to start with 2 times a day 75mg Lyrica.
I don't know anything about Zyprexa. Good luck Sam 😃
That's a strange combination, especially for anxiety.
Dr. Marks, could you make a video talking about mood stabilizers, how they work, and their side affects? I recently started taking them for bipolar disorder.
Thanks for the suggestion. I’ll add it to my list. Next weeks video talks about medications but it’s a little bit different emphasis. But it still may answer some of your questions.
How about deep brain stimulation is it provided for depression
CES works wonders for me!!!
Me too it helps me get to sleep!
Do you have experience with patients on esketamine or ketamine? Or know it’s effectiveness?
I've had a few patients get it and have good results. The issue is keeping up with the maintenance
Let's go baby that ez millions ✌️😆💰
I am getting deep TMS and the results are shocking to say the least. I feel so much better with little to no side effects other than jaw clenching during the treatment. In the past I have received ECT which worked but it caused serious memory loss.