Oct. 1, 2006
Changing Minds: Area 25
Experimental Brain Surgery May Help The Severely Depressed
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Reporter's Notebook: Stahl
Only On The Web: "60 Minutes" correspondent Lesley Stahl discusses a new experimental treatment on a certain region of the brain, which could help treat cases of severe depression.
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Area 25
A new experimental treatment on a part of the brain known as Area 25 may help those who suffer from severe depression. "60 Minutes" correspondent Lesley Stahl has more.
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(CBS)
But as correspondent Lesley Stahl reports, early results from an experiment in Canada have raised hopes for an answer to their suffering. It involves surgery on a region of our brains called Area 25. And, for the small group of patients who have signed up, the risks seem worth taking, because this is their last resort.
"It's kind of, for me, just a feeling of sadness, hopelessness, overwhelming," says 49-year-old Debra Prupas of Toronto. She was diagnosed with depression 15 years ago. It would seem that Debra had little to be depressed about, with a career as a high-level lawyer, a new husband, Bern Grush, and two daughters adopted from China.
"I call myself the great imposter," Prupas says. "I could fake my way through it. People - nobody knew. And then in the past few years, I've not been able to do that. I can't even get out of bed."
Debra has tried everything: numerous psychiatrists, anti-depressants: more than 30 different kinds, and a dozen electric shock treatments. Nothing worked.
Spending up to 18 hours a day in bed, Debra had to abandon her job, stop seeing friends and had thoughts of suicide. That left Bern taking care of her and the children.
"I'm just absent. I don't want to go out with my husband. I don't want to talk to – I withdraw," she says. She even withdraws from her daughters.
Coincidentally, at nearby Toronto Western Hospital, researchers had started a pilot study on a new treatment for people like Debra.
Studying the brain scans of severely-depressed patients, Dr. Helen Mayberg, the study’s lead neurologist, kept seeing that a small almond-shaped node was in over-drive.
"The area of the brain that was the most active was Area 25," Dr. Mayberg explains.
Area 25 – deep in the very center of our brains – is connected to other areas that control sleep, appetite and drive, all the things that go haywire when someone’s depressed. Mayberg’s theory is if you cool off area 25, you treat the disease.
She decided to try a technique called deep brain stimulation, that involves threading two thin electrodes through the brain, directly into Area 25 and stimulating it with continuous pulses of electricity from a pacemaker in order to jolt it back to normal.
Mayberg’s research partner, neurosurgeon Andreas Lozano, says it’s a far more targeted treatment than anti-depressants.
"The difference is, with antidepressants, that the 100 billion neurons in your brain get the drug. And here we estimate that we're affecting only a few hundred thousand neurons. And so, this is a surgical strike," he explains.
And like any brain surgery, there are risks, like stroke or infection.
Produced By Karen Sughrue
©MMVI, CBS Broadcasting Inc. All Rights Reserved.
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See all 61 CommentsAfter sufering with depression all my life and having ECT treatments. I am ready for something to work..
Was curious....does anyone know the anti-depressants or other medications the two patients were taking in conjunction with the DBS operation?
Thanks.
I have tried to keep up on any new breakthroughs and treatment for depression, but I admit the treatment on your show was new to me. I will definitely find out more.
Thank you...
Linda
Thank you
Paulette
I am also trying to get the VNS but the psychiatrist said that if u have been on more than 7 anti-depresaants it will not work. I do not know where she got her information from.
So, I am in search of a new psychiatrist. If anyone has any answers please please post!
Barry Mead
Tempe, AZ
I DO NOT KNOW WHAT ELSE TO DO FOR HIM. HE IS LEFT TO SUFFER IN HIS OWN PRIVATE HELL YEAR AFTER YEAR. HE NEEDS HELP BUT ALL DOORS SEEM CLOSED. . HE NEEDS COMFORT AND SANITY. IS THAT ASKING TOO MUCH?
HOW CAN THE MEDICAL AND PSYCHIATRIC PROFESSIONS ALLOW SUCH INHUMANE TREATMENT?
IF ANYONE CAN PROVIDE ME WITH INFORMATION HOW I CAN GET MY HUSBAND LONG-OVERDUE PALLIATIVE CARE, PLEASE LET ME KNOW AS SOON AS POSSIBLE. HE'S DROWNING IN HIS OWN SNAKE PIT OF MENTAL TORMENT.
piasecki@jps.net
he results of this therapy!! S Put VNS in your search and a case manager might be able to help with your area, I do not have any financial connection to the company.
Please get me in touch with the persons who can make this decision, This would be a Godsend for me.
my name is Frances Rose, address, 3405 Erickson St. C-7, Gig Harbor, WA 98335.
Phone 253-238-6426, Thank you!!!
On June 4, 1994 I was mountain climbing and fell
over 30 feet. I was in a coma with post-hematoma syndrome (bleeding of the brain). Since then I have seen many Dr.'s and Psychiatrist for post concussion and presently have post traumatic syndrome. I am a veteran of the US Army and the government has also diagnosed me with post-tramtic syndrome. I was a successful young college graduate at the time of the accident, but since then I must say life has had its ups and downs. Dr. Hosapian, my VA psychiatrist has said that I have massive depression. My Kaiser Dr. at the time of the accident told me that I should not go back to work in 1995, but I tried and have lost many jobs due to my condition.
My question to you is can I be a candidate for the treatment you aired on Sundays 60 minutes?
I do not like taking the pills that Dr.'s consistently give me with no recovery to the problems I have.
Please help me and or give me the contacts to become a candidate for research.
This was quite a story you did and I commend you on your reporting of this incredible phenomenon.
It could be the answer to many War Veterans who suffer from the same symstoms I do!
Again great story!
Dan Johnston
in 30 days in 1984 a gentleman cleared my severe depression in less than 30 days.
The techniques used allowed the Anger and Fear, embedded in the subconscious without human language to become identified and desensitized.
The specific techniques are not widely known today.
I'd love to share this story with you.
Paul Rieker
www.BlessYourThoughts.com
I would give ANYTHING to be included in the upcoming U.S.trials. Is there anyone out there who could get me information?
PLEASE HELP. I am desperate to have a life for the little time I have left.
Bonnie
blord2@adelphia.net
carrieb@nativeweb.net
Please e-mail me brenda57@tampabay.rr.com
Please help me.
A very interesting report on a possible treatment for depression. In the report it was mentioned that they had tried everything to help their condition. However, I did not hear any mention of NUTRITION. Most if not all conditions of depression and anxiety are related to nutritional deficiencies.
I suggest your staff research the work of Orthomolecular Medicine specialists like Dr. Abram Hoffer. Or look into the messages of Jefffrey S. Bland, PhD, and many other Nutritional Biochemists out there. Also listen to the taped broadcast program by Mr. Jay D. Foster at
http://1800chemist.com/HealthConnection/taped/05-06-04.ram
His Home pages is http://1800chemist.com/HealthConnection/index.html
There are routine analyses that can establish the nutritional needs that will address the specifics of the problem for each individual. It is sad to see people suffering unnecessarily.
A follow up 60 Minutes segment, telling the %u201Cwhole story%u201D would be in order.
Sincerely,
Johan F. Ploeg
2)It will save the government and insurance companys a lot of money
3)It will put alot of people back in the work force
4) It will put a lot of psychology people out of work
5) When you take away a persons survival drives, (as in todays society) they become depressed. They need to be in control of thier own desinty and future.
My name is Phil. I have had depression and bipolar disorders for atleast 10 years but that is when I was diagnosed with it. My doctors think I had it much longer than that. I saw this story last night and all I could think of is to give my life to get that operation. I am trying to get SSI but as I am sure alot of people know the government doesn't see depression or many maybe even any mental illness as a disability. The government sees us as lazy people wanting to get out of work and that is how we feel when we can't work. I litterally cannot get up and leave my apartment. I sleep in surplus of 14hrs a day and that is if I sleep. My entire family suffers from depression and over 11 people on my moms side of the family have atttempted suicide and 3 succeded. I have tried countless times and all I want to do is die. I feel there is no point to life. I have been on over 20 different drugs and nothing works. All I want is to be a normal contributing citizen working like everyone else. But, what people don't understand is how hard it is for us. I am asking you guys if there is any way I can get to be a part of this new medicine? I will give anything to be a test subject. I would give every limb and organ I could just to be a part of it, hell I would give my life too. Please help me. I beg you.
squirrel5911@yahoo.com
Please help.
and brought light to efforts being made in the
treatment of severe untreatable depression.
I would have preferred Ms. Stahl ended the story
with Dr. Mayberg who not only discovered area 25
but instructed the surgeon where to put the DBS.
Since the surgeon is neither a Psychiatris or Neurologist
and was only involved because he was at the University
it seems odd to have him discussing patient care.
One other oversight was the mentioning of Medtronics.
While the research did use a Medtronics stimulator there
involvement ended there. The Medtronic trial involves a
different part of the brain other than Area 25 and have yet
published in the scientific community a paper that shows
the success rate of Dr. Maybergs work in Area 25. Since
Medtronics is a publicly traded company it seems a correction
is inorder and the mentioning of them along with a still shot
of there corporate headquarters a mistake.
I am a 67 year old Jewish, female nana, originally from The Bronx.
My resistent to treatment depression has influenced the quality of my life since college, when I experienced my first episode.
For the next 40 years, I used the following approach to the condition:
1. the primary attack was psychotherapy, even 4 years of psychoanalysis. Coming from a highly dysfunctional family - filled with depression, neuroses, schizophrenia, suicide and physical violence - I was sure I could overcome my situation thru reliving the endless triggers that were my growing up life story.
I finally, reluctantly ended talk therapy when I had to call my psychiatrist from Princeton House to cancel my next appt.
2. The secondary attack was thru medicine. My husband,was a research scientist at J&J, was deeply commited to this modality of treatment. I tried every pill on the market, many times over time. No difference.
3. Today 's mode of treatment? ECT maintenance therapy at Uof Penn. in combination with a healing lifestyle that includes
4. Yoga, Meditation, Exercise and Sports, respectible eating habits, and moderation.
I'm glad you see fit to include new advances in the treatment of Depression as a worthy topic for 60 Minutes. We still have such a long way to go in treatment and even the identification of symptoms associated with Depression.
Keep up the good work!
You did a terrific report about a very complicated subject and surgical procedure. You asked good scientific, business and human questions.
Viewers should be aware that there is a new FDA approved neurostimulation procedure for severe or chronic depression called vagus nerve stimulation. The ninety-minute out-patient procedure is not related to brain surgery or shock treatments. It has been proven to be highly effective in patients with the most treatment-resistant form of depression.
Depression sufferers should be asking their psychiatrists about vagus nerve stimulation, which is readily available in the United States.
Watching your story got me and most of the other inpatients really excited. Some were talking about hospitals in the U.S. that were already conducting the surgery...that part I couldn't find in your story on the web. Do you have that information? I am definitely interested in performing this surgery as I am sick and tired of feeling like someone hit me on the head and experiencing life as if I have glue on the soles of my shoes slowing me down in everyhing I try to do.
Waiting for your response
Rabab
301-535-0757
6729 Mink Court - Waldorf, MD 20603
Note: Can I get a ttranscript or a video of the story?
I am sorry I don't have the time to respond to this with the forethought and time it deserves. I have treatment resistant depression, anxiety disorder, & panic attacks. I%u2019ve been on at least 16 different meds (multiple times & combinations), I have had 12 ECT treatments that kind of helped, but gave me so much anx&panic that I actually became depressed again. I was desperate and certainly suicidal (prior to and after) ECT. I looked long and hard into Vagus Nerve Stimulation (VNS). It sounded great, at first. I slowly became aware of its LOW success rate (33% partial recovery after 1 year & 2-3% chance of full recovery).
Also, VNS can cause some pretty severe side effects. The side effects are not all listed in the official literature because there have been so few controlled studies. I learned of the unpublished side effects from a phone conference sponsored by the manufacturer of the VNS device. There were real patients %u201Cunscripted%u201D at the end of the call. One had SEVERE pain (uncontrolled), many had trouble swallowing or constant cough or their voice was permanently at a whisper volume, etc... I was going to get the VNS surgery done anyway. There were so few doctors that will even touch this treatment with a ten-foot-pole (I am talking about doctors in the military who gain nothing by doing or not doing this procedure). Most said they wouldn't do the surgery because of the low success rate and that they were concerned that their patients would be so disappointed that they would commit suicide, and that the only surgeries they do are on those who are pretentious about the success VNS offers. I told them that the 2% chance was worth the risk.
I ended up with an unplanned pregnancy which halted the process of having VNS surgery. Now that I have 5 more months to consider VNS, I am really scared about the side effects. That is why I was so excited to see the 60 minutes report on DBS & area 25, as it seems like it has the same goal as VNS but skips the step that causes the side effects and goes right to the source of the problem. I think I will wait for future discoveries in the treatment of depression. Unless, of course, my depression returns fully after my baby is born. Suicide doesn't sound good to me as a solution. Please DO YOUR OWN RESEARCH on all the treatments available. There is a lot of new stuff out there, and more coming.
Take Care All!
inate eccentricites of my parents 'friends probably masked many things. At 16, during my first year at GU, I attempted suicide' and was treated by Kalinowski with EST. I did graduate, but from then, by turns, I was in the hospital or somewhat active outside. Sleep, family suicides,pills...treatment resistant depression... thus, I now go on. I would really like
to try the DBS, as it is very difficult to endure this sadness. I did go for a VNS interview,but was rejected because I cycle to rapidly.
I would like to thank 60 minutes and Leslie Stahl
for presenting such a sensitive and well written
report.The subsequent comments only begin to reflect the enormity of this problem.
I've been treated for major depression for over 20 years, I would be very interested in participating in the clinical trials for deep brain stimulation here in the US. Do you have any contacts for this program? If so , please email them to me, or post a link.
hopeful in Texas
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