Deep Brain Stimulation Treatment for Depression

Deep brain stimulation (DBS) has been recently introduced to treat severe depression. The Toronto Globe and Mail has a fascinating article ” Mending a Broken Mind” which looks at the treatment from both a medical and human interest perspective. Prior to treatment for depression, DBS has been used to treat Parkinson’s.

Mindful Awareness and Depression: Part I Seeing the Pattern

The book The Mindful Way Through Depression has a great chapter called ‘The Healing Power of Awareness”. A summary of the main points begins this post while other points are summarized in Mindful Awareness and Depression: Part II Doing Mode and Part III Being Mode.

The authors of the book explain how our reaction to negative feelings in the present drag us down to where hurtful memories and feelings from the past takeover.

Here are the downward steps:

1. We experience an afflictive emotion such as sadness.
2. Powerful feelings of deficiency or inadequacy from the past come into the present.
3. We are unable to switch our attention back to what we were doing.
4. This negative state has 2 effects on the mind. A.) They make us more unhappy and ; B.) our perceived deficiencies and inadequacies take on an urgency which demands that we fix them.

People with depression are now entangled in such a way it’s nearly impossible to think or feel any differently.

If we are able to see this pattern at work in ourselves, we might be able to let the depressed thoughts and feelings drift by and bring ourselves back to the present. We also might see ourselves in a more compassionate light.

In order to begin to unravel ourselves from this mess, we must first pay attention to the depressive thought pattern we automatically get caught up in.

Why are we happy? Why aren’t we happy?

Here is Dan Gilbert’s 20 min video lecture Why are we happy? Why aren’t we happy? at the TED Symposium. He’s another Harvard professor. Cambridge, MA must be one happy place.

Gilbert is a very entertaining speak. And presents empirical data which shows that our brain is wired in such a way that we tend to overate our longings and fears. He also demonstrates that we have the ability to create our own happiness but often our emotional overreactions can get in the way.

After his lecture it occurred to me that two of the foundational elements of our modern day society can -if we let them- be obstacles to our sense of wellbeing. The combination of the personal freedom that we have and an economy built on buying the next shiny thing are catalysts for a person to overate how the fulfillment of their own desires can make them happy.

The whole purpose of marketing is to elevate our longing for stuff while the idea that “I can choose this or that” or “I should have chosen this or that” can easily make us take our eye off the ball when it comes to taking in the experience of what we already have.

Perhaps I am being to philosophical. Anyway Gilbert’s lecture is fun to watch.

Harvard’s Highway to Happiness

Here is video of Harvard Professor Tal Ben-Shar’s lecture on Positive Psychology: Science of Happiness: How to Get Happy.

He begins by briefly explaining the philosophy behind the positive psychology movement followed by a detailed exploration of his 6 tenets of happiness. My notes from the lecture gives you good idea of the content.

Philosophy Positive Psychology

1. Discipline began by Dr Martin Seligman in 1998
2. In 1998 ratio of articles the psychological pathology to articles about wellness was 21:1
3. Health is not the absence of disease
4. Positive psychology strengthens the immune system

Six Tenets of Happiness

1. Give yourself permission to be human
2. Simplify your life
3. Finding meaning and pleasure
4. Have meaningful interpersonal relationships
5. Work the mind-body connection
6. Focus on the positive.

See the video.

Stigma Among the Enlightened

“Society’s silence about mental illness is deafening. When you are diagnosed you disappear. …’There’s this attitude out there that if you come back from cancer, you’re a hero, but if you come back from depression, you’re damaged goods.’” from Andre’s Picard’s article about mental illness in Canada Toronto’s Globe and Mail

Depression seems to extract an even greater toll from the community of physicians. “[T]here are still pockets of stigma in a society like medicine. It’s a paradox: The healer can’t be sick.” The suicide rate for male doctors is twice the average for the general population; the rate for female physicians double the rate of male physicians. Read more.

But there is a price. The late treatment, severity of symptoms and easy access to potentially lethal drugs – along with the pervasive stigma in society – means the rate of suicide among male physicians is about twice that of the general population. Among female physicians, it is about four times higher.

What the Most Satisfying Moments in Life Have to Do with Depression

Can the psychology of optimal experience help people with depression?

In his book Flow, psychologist Mihalyi Csizkezentmihalyi identifies the 7 universal qualities of personal optimal experience, those that people find most satisfying.

1. Challenging Activity That Requires Skills

2. Merging of Action and Awareness

3. Clear Goals and Feedback

4. Concentration on the Task at Hand

5. Lack of Worry About Losing Control

6. Loss of Self-Consciousness

7. Transformation of Time

He has studied people from all over the world who’ve described what it was like to do something they loved.

Our attention is key to the optimal experience. Of all the internal and external stimuli we are exposed to in any given moment, it is attention that selects what is brought into our conscious experience.

The author calls attention psychic energy. Life is great when our attention aligns with our intention. If they are misaligned, we’ve got problems. Csizkezentmihalyi calls this psychic disorder.

“We give this condition many names, depending on how we experience it: pain, fear, anxiety or jealousy. All these varieties of disorder force attention to be diverted to undesirable objects, leaving us no longer free to use it according to our preferences. Psychic energy becomes unwieldy and ineffective.” – Flow The Psychology of Optimal Experience.

Sound familiar.

Back to the 7 qualities of optimal experience, all of them involve the capture/direction of attention. In an optimal experience, a person’s skills that he enjoys using are being challenged and developed. He is one with the test. Focus is on the skill and not the outcome. The experience has a game-like quality; the activity an end in itself.

There is no self; no worry; no time; no extraneous thought.

See if there are any activities in your life that capture your attention this way and look at your experience. Can you apply it to other aspects of your life.

Csizkezentmihalyi is saying that attention determines the quality of experience. This principle has enormous potential to help people with depression.

If we can refine our ability to direct the focus attention we will be in a better position to control the quality of our experience. Could we apply the principle to even the most mundane chores of daily life?

There will be a lot more posts on the subject of attention.

You Never Saw John Wayne Cry

Who Would You Rather Be?

• “We all know individuals who can transform hopeless situations into challenges to be over come, just through the force of their personalities. This ability to persevere is the quality people most admire in others; and justly so.” – Mihlay Csikzentmihalyi, talking about “ordered consciousness” from his book Psychology of Optimal Experience

• “… Hypersensitivity to adversity, vulnerability in the face of stress, withdrawal from intimate connections, premature aging, sluggishness in recovery, deteriorating course, chronicity of impairment, failed resilience….” Dr Peter Kramer, describing “symptoms and traits that characterize depression” his book Against Depression

People who have chronic depression or bipolar disorder appear far removed from the heroic archetype. So removed that their manner can make others very uncomfortable.

Who would actually want to live their lives this way? I have overcome alot in my life. Why can’t they? Whatever is ailing them I don’t want any part of it. The world is a dangerous place. You can’t count on them. They don’t have the mettle to take the bumps and bruises of life. If I associate with them, people would think I was weak. Weak is not allowed. This is the mindset we are up against.

Kramer describes the inner challenge those of us with depression face.

Depression One of the Planet’s Most Devasting Diseases

If you were asked to name the world’s most dangerous diseases, depression probably wouldn’t rank high on your list. You would most likely think of diseases like heart disease and cancer.

But researchers have discovered that the amount pain and loss caused by depression makes it a rival for the top spot.

Consider the facts:

• The World Health Organization states the amount of healthy days lost to depression makes it the fourth largest cause of disability in the world. By 2020 depression will be leading cause of disability.

• Medical professionals conclude that disability caused by depression damages the individual more than any other disease.

• Aside from early childhood fatal diseases, depression steals more potential healthy days away from people than any another illness.

• Due to lost productivity, depression causes $40 billion in the American workplace. That’s 3% of the entire gross national product.

• Depression ranks along with high blood pressure, smoking, stroke and congestive heart failure as a risk factor for death in the elderly. Studies show if you are depressed at age 65 your chances of dying before age 72 is increased 24%.

One last thing over 850000 people will take their own lives this year.