A non-invasive method of brain stimulation that relies on electromagnetic induction using an insulated coil placed over the scalp which creates a magnetic field to induce a small electric current in a specific part of the brain.

Transcranial Magnetic Stimulation 

Repetitive Transcranial Magnetic Stimulation (rTMS) is a non-invasive treatment that repeatedly sends a high-intensity magnetic pulse into a particular brain area. In electroconvulsive therapy, the patient is anesthetized to control seizures and muscle relaxers to control the violent jerking, but during rTMS, there is no need for anesthesia, avoiding many complications. The treatment is showing promising results in relieving symptoms of mood disorders, specifically depression, and is preferred when other treatments have failed. 

Repetitive Transcranial Magnetic Stimulation (rTMS)

The vagus nerve is part of the autonomic nervous system and is linked to the brain's hypothalamus and amygdala areas, which have shown an association with mood disorders. With VNS, small electrodes are attached to the vagus nerve, which connects to an electronic device surgically placed in the left chest wall. Not enough studies have yet been done to distinctly understand why it relieves mood disorder symptoms, but it looks promising.

Vagus Nerve Stimulation (VNS) for Mood Disorders

Electroconvulsive therapy (ECT) is a biologically based treatment for severe mental disorders, particularly severe depression that has not responded to drug therapy. The procedure involves using an electrical current to induce seizures, which helps alleviate symptoms. While the exact mechanism of action is not understood, ECT has a high success rate, with about 85% of patients showing improvement. However, due to significant side effects like memory loss associated with repeated treatments, it is typically implemented as a last resort.

Electroconvulsive Therapy (ECT)

Treatments that are either no longer used or are used in a different way based on research. (ECT, TMS, rTMS, VNS)

University of Toledo

- Antidepressants 
- Mood stabilizing medication 
- Psychotherapy 
- Alternative treatments (electroconvulsive therapy, transcranial stimulation)

Mood Disorder Treatments

Nolen-Hoeksema, S. (2020). Abnormal Psychology (8th ed.). McGraw Hill.

Abnormal Psychology

A type of psychotropic medication prescribed for anxiety and agitation that occur in OCD, PTSD, panic disorder, and social phobia. Common brand names include benzodiazepines such as alprazolam (Xanax) and lorazepam (Ativan), and diazepam (Valium).  They work as GABA agonists. GABA is a neurotransmitter responsible for the suppression of brain activity which assuages anxiety. Other medications such as buspirone (Buspar), antihistamines, and beta-blockers can also be used as anxiolytics to treat the physiological symptoms of anxiety such as racing heart.

Anxiolytics/Anti-Anxiety Agents

Antipsychotics are a drug class used to treat psychosis and other related disorders, such as schizophrenia. There are two types of antipsychotics: first-generation or typical antipsychotics include drugs like haloperidol, and second-generation or atypical antipsychotics include drugs like risperidone. Common brand names include Haldol, Mellaril, Prolixin, and Thorazine.

Antipsychotics

Antidepressants are psychotropic medications prescribed to alleviate symptoms of mood disorders like depression and anxiety. They work by addressing chemical imbalances of neurotransmitters in the brain. Different types of antidepressants target different neurotransmitters; for example, selective serotonin reuptake inhibitors (SSRIs) increase the availability of serotonin, while serotonin-norepinephrine reuptake inhibitors (SNRIs) elevate the levels of both serotonin and norepinephrine. Common SSRIs include Prozac and Zoloft, while tricyclics include Tofranil and Elavil.

Antidepressants

Alternative Treatments for Mood Disorders

A patient has been diagnosed with severe, treatment-resistant depression, having shown no improvement after trials with multiple antidepressant medications and various forms of psychotherapy. A clinician suggests electroconvulsive therapy (ECT) as the next step. Evaluate this recommendation. In your response, you should weigh the potential benefits of ECT for this type of patient against its associated risks and societal stigma. Conclude with a justified argument for or against proceeding with this treatment.

Evaluating a Treatment Recommendation for Severe Depression

Based on the following case study, evaluate the initial treatment plan and propose a more appropriate therapeutic strategy, explaining your reasoning.

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