4 ms·

I'm glad this is helping some people, and I'm always in favor of treatments that help people who are "lost causes" (people with chronic illness and every treatm

I'm glad this is helping some people, and I'm always in favor of treatments that help people who are "lost causes" (people with chronic illness and every treatment they tried so far has failed), but this stuff really creeps me out. There's that story of the Navy SEAL that developed mania and psychosis from excessive use of rTMS that was making the rounds a few years ago (https://rewired.inewsource.org/ucsd-kevin-murphy-prtms-navy-seals.html https://rewired.inewsource.org/ucsd-kevin-murphy-prtms-navy-...). It just seems like an example of scientists playing around with a complex system they have a very incomplete understanding of, with potentially risky outcomes. The brain isn't a heart, it's not just a matter of getting it "beating" at the right pace. With the Navy SEAL who went insane, the main problem seems to have been excessive treatment (rTMS worked at first, but the effects kept going away without more stimulation, so even though he was supposed to be "cured" after a few months and require no further treatment, he had essentially become "addicted" to brain stimulation). Brain stimulation implants seem too similar: meant to stimulate certain emotions in perpetuity, with nothing really addressing the underlying causes. Psychotropics are already suboptimal in that same sense (addressing symptoms, not root causes) but it seems like a safe bet that this will have more unintended effects than drugs. I don't want to discourage anyone here from getting treatment (as a sidenote, what worked for me for depression was internal family systems therapy, which is also pretty "out there" and cutting edge) but I'm wary that with more focus and funding for rTMS, there'll be less attention on finding more "root cause" solutions.

hprotagonist 5y ago
This is DBS, similar to therapies for motor disorders like Parkinson’s. It’s also invasive; a surgery is performed to implant an electrode into the striatum. rTMS is noninvasive and much less targeted. Based partly on motor disease research into disorders like Parkinson’s disease, there is a growing theory in the neurosciences that brain disrhythmic behavior is the root cause for a variety of disorders, with a plastic feedback loop on top that reinforces things as the disease progresses. Closed-loop stimulation that disturbs the maladaptive behavior when it starts works stunningly well for some motor diseases, and at least in one patient, for MDD as well.
- concinds 5y ago
  Interesting, that makes me trust this quite a bit more. Regardless, this is bound to really contribute to our understanding of the brain, so I'm grateful for this research.
  - chofpsychiatry 5y ago
    Absolutely! Sometimes for treatment the person doesn't even have to be depressed![1] Its like all those animal rights activists who get their knickers in a knot when a child dissects his pet dog. Don't they know that while it's alive there's more to learn? [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953640/#__ffn_sectitle https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953640/#__ffn_... (edit: "While it's alive" could be interpreted as meaning not to engage in invasive, involuntary treatment at all, due to its riskiness. This was not the intention. There's a sweet spot in one's learning where a subject will yield any information one desires of it in its attempt to prevent the inevitable, as concinds implies.)
maybelsyrup 5y ago
Great comment. > but the effects kept going away without more stimulation, so even though he was supposed to be "cured" after a few months and require no further treatment This describes most mental health treatments, especially the drugs. > internal family systems therapy I'm a huge fan of this, too. Did wonders for my relationships. > that story of the Navy SEAL This is fascinating. Given what you read about these guys these days, needing serious professional help doesn't exactly surprise me.
fpgaminer 5y ago
> It just seems like an example of scientists playing around with a complex system they have a very incomplete understanding of, with potentially risky outcomes. Scientists don't "play" around with medicine; this kind of stuff is highly regulated. TMS is only used to treat depression when all other treatments have failed. At that point, the benefits outweigh the risks. Namely, at that point the patient is at risk of _death_ and no other options are available. > Psychotropics are already suboptimal in that same sense (addressing symptoms, not root causes) We don't know the root causes of the vast majority of diseases. So we can't say whether psychotropics treat the root causes or not. But we do know they work. They save and improve many, many lives. And that's how modern medicine works. Does it work? Is it safe? Then we use it. All modern day treatments are suboptimal. That doesn't mean they don't work, and that doesn't mean people shouldn't use them when needed. It's interesting that I don't see these kind of skeptical comments about antihistamines. Modern antihistamines are suboptimal (I should know), but everyone with allergies is glad they exist. > I don't want to discourage anyone here from getting treatment Personally I think this comment will contribute to treatment hesitation, whether that was intended or not. Mental health is already highly stigmatized, and seeking help for it is a daunting task. Telling people that scientists are "playing" around with their brain isn't helpful. Good doctors are following a strict, science backed playbook for the treatment of mental disorders. These playbooks save lives.
- concinds 5y ago
  > Personally I think this comment will contribute to treatment hesitation You're right; I want to make sure to say that people should never, ever just decide to "live with" whatever ails them. There's solutions, and 99% of the time the price is worth paying. Exhaust your options but never "settle" for "this is just how my life will always be", whatever works, works. I have psychiatrists in my family so I know for a fact that psychotropics can turn someone's whole life around, durably, and do a 360° on their quality of life; and sometimes have their lives literally saved. I don't want anyone reading this to think I'm on the "antipsychiatry" side of things. I was approaching this from a "medical technology" PoV, hoping that there would be more effective, permanent treatments by now, but I hope if there are any patients or future patients reading this, that they don't write this off if nothing else worked. Don't necessarily trust every doctor (if they give you treatments that don't work or don't listen properly to your symptoms) but do listen to your doctor once you find a good one, which there are a lot of. I was using the "playing around" language out of the frustration that everyone who does have chronic illness that doctors have been unable to address (even with experimental treatments), knows. But it's very important people don't throw out the baby with the bathwater, and even more important to do whatever it takes to become unencumbered by whatever problem they have. I can't edit my comment above anymore, but I just want to say, if you have a chronic condition, you seriously can't imagine how much better your life will be once you get it under control. Trust the process, you can find solutions no matter how hopeless it feels.
davesque 5y ago
I highly agree with this sentiment. After all, it seems in a way that emotions are a reaction to the environment and to one's circumstance. If those are poor, shouldn't the emotions also be poor in a healthy person? Otherwise, what incentive would a person have to seek out a better situation? In my own struggles with depression, I feel one truth I've discovered is that my emotions are calling attention to things in my life, both good and bad. That's useful. I wouldn't want to always feel good about everything. That's why I hope treatments like these are looked at as providing some kind of temporary relief that could help a person find motivation to change things that are bothering them. I know the kind of negativity a person can experience during depression can be totally debilitating. It should treat that debilitation.
- chofpsychiatry 5y ago
  You are taking your well-being, happiness and choices over your physical body into your own hands. What kind of country would it be in which everyone did that? In what kind of country would one expect those kind of liberties to be protected? How successful could it possibly be? Surely, there is noone who would want to stand up to preserve such a way of life. Instead, look to the Eastern bloc for inspiration and guidance. Look how much money there is to be made by being a facilitator as, while ensuring outright war remains too costly, the superior manpower of the East infests non-meritocratic governing bodies that increasingly exercise power over Western policy decisions - and let us always continue to give the science of mental illness our praise.
throwaway81523 5y ago
https://en.wikipedia.org/wiki/Wirehead_(science_fiction) https://en.wikipedia.org/wiki/Wirehead_(science_fiction)

hprotagonist 5y ago

This is DBS, similar to therapies for motor disorders like Parkinson’s. It’s also invasive; a surgery is performed to implant an electrode into the striatum. rTMS is noninvasive and much less targeted. Based partly on motor disease research into disorders like Parkinson’s disease, there is a growing theory in the neurosciences that brain disrhythmic behavior is the root cause for a variety of disorders, with a plastic feedback loop on top that reinforces things as the disease progresses. Closed-loop stimulation that disturbs the maladaptive behavior when it starts works stunningly well for some motor diseases, and at least in one patient, for MDD as well.

concinds 5y ago
Interesting, that makes me trust this quite a bit more. Regardless, this is bound to really contribute to our understanding of the brain, so I'm grateful for this research.
- chofpsychiatry 5y ago
  Absolutely! Sometimes for treatment the person doesn't even have to be depressed![1] Its like all those animal rights activists who get their knickers in a knot when a child dissects his pet dog. Don't they know that while it's alive there's more to learn? [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953640/#__ffn_sectitle https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953640/#__ffn_... (edit: "While it's alive" could be interpreted as meaning not to engage in invasive, involuntary treatment at all, due to its riskiness. This was not the intention. There's a sweet spot in one's learning where a subject will yield any information one desires of it in its attempt to prevent the inevitable, as concinds implies.)

maybelsyrup 5y ago

Great comment. > but the effects kept going away without more stimulation, so even though he was supposed to be "cured" after a few months and require no further treatment This describes most mental health treatments, especially the drugs. > internal family systems therapy I'm a huge fan of this, too. Did wonders for my relationships. > that story of the Navy SEAL This is fascinating. Given what you read about these guys these days, needing serious professional help doesn't exactly surprise me.

fpgaminer 5y ago

> It just seems like an example of scientists playing around with a complex system they have a very incomplete understanding of, with potentially risky outcomes. Scientists don't "play" around with medicine; this kind of stuff is highly regulated. TMS is only used to treat depression when all other treatments have failed. At that point, the benefits outweigh the risks. Namely, at that point the patient is at risk of _death_ and no other options are available. > Psychotropics are already suboptimal in that same sense (addressing symptoms, not root causes) We don't know the root causes of the vast majority of diseases. So we can't say whether psychotropics treat the root causes or not. But we do know they work. They save and improve many, many lives. And that's how modern medicine works. Does it work? Is it safe? Then we use it. All modern day treatments are suboptimal. That doesn't mean they don't work, and that doesn't mean people shouldn't use them when needed. It's interesting that I don't see these kind of skeptical comments about antihistamines. Modern antihistamines are suboptimal (I should know), but everyone with allergies is glad they exist. > I don't want to discourage anyone here from getting treatment Personally I think this comment will contribute to treatment hesitation, whether that was intended or not. Mental health is already highly stigmatized, and seeking help for it is a daunting task. Telling people that scientists are "playing" around with their brain isn't helpful. Good doctors are following a strict, science backed playbook for the treatment of mental disorders. These playbooks save lives.

concinds 5y ago
> Personally I think this comment will contribute to treatment hesitation You're right; I want to make sure to say that people should never, ever just decide to "live with" whatever ails them. There's solutions, and 99% of the time the price is worth paying. Exhaust your options but never "settle" for "this is just how my life will always be", whatever works, works. I have psychiatrists in my family so I know for a fact that psychotropics can turn someone's whole life around, durably, and do a 360° on their quality of life; and sometimes have their lives literally saved. I don't want anyone reading this to think I'm on the "antipsychiatry" side of things. I was approaching this from a "medical technology" PoV, hoping that there would be more effective, permanent treatments by now, but I hope if there are any patients or future patients reading this, that they don't write this off if nothing else worked. Don't necessarily trust every doctor (if they give you treatments that don't work or don't listen properly to your symptoms) but do listen to your doctor once you find a good one, which there are a lot of. I was using the "playing around" language out of the frustration that everyone who does have chronic illness that doctors have been unable to address (even with experimental treatments), knows. But it's very important people don't throw out the baby with the bathwater, and even more important to do whatever it takes to become unencumbered by whatever problem they have. I can't edit my comment above anymore, but I just want to say, if you have a chronic condition, you seriously can't imagine how much better your life will be once you get it under control. Trust the process, you can find solutions no matter how hopeless it feels.

davesque 5y ago

I highly agree with this sentiment. After all, it seems in a way that emotions are a reaction to the environment and to one's circumstance. If those are poor, shouldn't the emotions also be poor in a healthy person? Otherwise, what incentive would a person have to seek out a better situation? In my own struggles with depression, I feel one truth I've discovered is that my emotions are calling attention to things in my life, both good and bad. That's useful. I wouldn't want to always feel good about everything. That's why I hope treatments like these are looked at as providing some kind of temporary relief that could help a person find motivation to change things that are bothering them. I know the kind of negativity a person can experience during depression can be totally debilitating. It should treat that debilitation.

chofpsychiatry 5y ago
You are taking your well-being, happiness and choices over your physical body into your own hands. What kind of country would it be in which everyone did that? In what kind of country would one expect those kind of liberties to be protected? How successful could it possibly be? Surely, there is noone who would want to stand up to preserve such a way of life. Instead, look to the Eastern bloc for inspiration and guidance. Look how much money there is to be made by being a facilitator as, while ensuring outright war remains too costly, the superior manpower of the East infests non-meritocratic governing bodies that increasingly exercise power over Western policy decisions - and let us always continue to give the science of mental illness our praise.

throwaway81523 5y ago

https://en.wikipedia.org/wiki/Wirehead_(science_fiction) https://en.wikipedia.org/wiki/Wirehead_(science_fiction)