February 11, 2009 5:56 PM

Changing Minds: Area 25

By
Daniel Schorn
(CBS)  Eighteen million Americans suffer from major depression. Most of them are treated successfully with a combination of "talk therapy" and anti-depressant drugs. But millions of Americans – possibly as many as four million - are afflicted with what is known as "treatment-resistant" depression. For them, nothing works, not even electric shock treatments. They endure lives of debilitating sadness and some end up committing suicide.

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.


Copyright 2009 CBS. All rights reserved.
Add a Comment See all 63 Comments
by sadnarkansas August 12, 2010 11:45 PM EDT
I too suffer from depression for 15 years and have tried all kinds of meds too. i have tried to commit sucide twice and have been in the mental hospital twice. I have been going to Ozark Guidence Center for the past 7 straight years and feel helpless. One Dr told me that they have given me all they knew how and I said, so this is it I no longer have hope??? He back tracted then. Still no better. Please if anyone can help I too would apply for the clinical test. Help!
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by OhWi June 26, 2009 3:32 PM EDT
Hi,my name is Bill and i have been afflicted with depression for most of my adult life.(I am a 40 year old male) It seems to affect everything i try,jobs,relationships ect.I have tried a dozen or so meds,talk therapy,CBT ect.Nothing works.I have a few years left,but i'm not going to make it if i don't find a way to turn the tide on this depression.I like DBS because it is targeted and permanent.Please,if anyone can direct me to a trial or a doctor that can help facilitate this procedure,it would be greatly appreciated.I am a veteran and get my care through the Vets hospital.If i have to pay for it i would be willing to pay(Beg,borrow or steal) to get the money.I am quite desparate at this point.So damm tired and want just a little relief.If you can help me please forward the realevant information to: cecilia-so@hotmail.com Thanks for listening.
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by by_annie April 13, 2009 3:08 AM EDT
Hello,

I am a Mongolian women. I am suffering from depression for 3 years. By chance i found out about DBS. I would like to know whether the surgery available for me or not.........please email me or post a link
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by redyankee47 October 4, 2006 4:36 PM EDT
Hello,
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 Louisiana
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by kmk1964 October 4, 2006 1:36 PM EDT
I was diagnosed with depression approx., 20 yrs. ago and have been on numerious anti-depressants and anti-depressant combinations and have had numerous ECT treatments. Do you have any information on the study for the deep brain stimulation area 25 that will be going on in the United States - I am very interested in being in this study.
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by spacestevie October 4, 2006 1:24 PM EDT
While this technique maybe well and good, we all know that the potential exists for abuse. As with all good things, there are those who would use this proceedure for recreational purposes. If legal, the clinics might be like those which perform plastic surgury today. If illegal, the back alley clinics would probably do the service. Either way, we have people today who would pay anything for a permanant high. There were people in the 60's who drilled holes in their heads chasing a permanent high. This seems the high tech version.
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by arlgtn February 2, 2010 2:24 PM EST
The potential for abuse for this procedure is highly unlikely. Having suffered from intractable depression for twenty years, I had the experimental surgery 7 months ago. I'm pleased to report I'm doing well. But I didn't/have not experienced a "high"; rather, now I experience life more the way healthy, "normal" people do. Second, the surgery is incredibly involved. I doubt many people without severe, untreatable depression would be willing to go through the risky, eight hours of surgery and recovery I had to go through. Third, the surgery is prohibitively expensive. Since I'm enrolled in a clinical trial my costs are covered, but I know the cost for the tests/surgery/hospital stay/follow up, etc. for me have exceeded $200,000. Again, not a good way to get a "high." Finally, patients are carefully screened prior to surgery.

I can see how it would seem that there is a potential for abuse with this procedure. But I think people who haven't been deeply depressed don't understand that depression treatments don't give someone a high. They just give them an opportunity to function in life without a crippling feeling of relentless despair.
by rmmerritt October 4, 2006 11:45 AM EDT
My name is Rhonda I have a 21 year old daughter who has been suffering from depression and other sychological disorders since she was 15 years old. Please help me find out how I can get her in the study for this new treatment area 25.
Thank you
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by chuck_the_czech October 4, 2006 2:47 AM EDT
Will insurance pay for this procedure? Can anyone point me in the right direction?
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by answers6 October 4, 2006 1:28 AM EDT
I have been bothered with muscle pains, joint pains, skin lesions, and depression for several years. One week ago I started my own treatment. Stay with me I started a Fungal treatment taken orally and in one week the pain is gone, skin problems clearing up, brain fog and depression gone and as a side effect I have lost 11 pounds. Please from a 57 yr old nurse keep searching because there is help out there and it is not always where you think!!!!!!!!!!
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by jreizes October 3, 2006 8:09 PM EDT
Newer treatments for depression are exciting developments and I believe brain science is the path to the future for those who suffer from this debiliatating and still misunderstood disease. Right now the best approach we have to making sure that depression does not become chronic and an unremitting way of life is early diagnosis and intervention. I work for a nonprofit organization that runs National Depression Screening Day which happens to be October 5th, this Thursday. If you or anyone you know is concerned about depression or a related disorder visit www.MentalHealthScreening.org to find a local nearby site. This public service project is completely free. Early detection, like with many other illnesses, is key.
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