Watching: DEPRESSION: Out of the Shadows
Chapter 10: Experimental Treatments [6:31]
New discoveries are helping people with treatment-resistant depression. Deep brain stimulation gave Deanna her life back.
Transcript: Chapter 10 - Experimental Treatments
NARRATION: (DEANNA BENJAMIN-COLE LOOKING OUT HOSPITAL WINDOW) But what about the one million patients who suffer from what is known as treatment-resistant or refractory depression for whom nothing works? Then what?
NARRATION: (DEANNA BENJAMIN-COLE LOOKING OUT HOSPITAL WINDOW, HOSPITAL FOOTAGE) At age 36, Deanna Benjamin Cole fell into a numbing depression. She could no longer function at work and withdrew from her husband and three young children. She spent most of the next four years inside this mental hospital in Canada.
DEANNA BENJAMIN-COLE: (VO, HOSPITAL FOOTAGE)At times, it was a very safe place to be,
DEANNA BENJAMIN-COLE: (OC) that I wouldn't have been safe somewhere else.
NARRATION: (DEANNA BENJAMIN-COLE WALKING IN HALL) Every possible medical and therapeutic treatment had failed, including eighty electroshock treatments.
DEANNA BENJAMIN-COLE: (VO, DEANNA BENJAMIN-COLE WALKING IN HALL) It got to the point where I thought everybody would be better off without me because then they wouldn't have to go through the pain of seeing me feel the way I was feeling.
DEANNA BENJAMIN-COLE: (OC) And that's a really, really, really scary place to be.
NARRATION: (DR. HELEN MAYBERG AT DESK) But one last thread of hope was offered. Working at the frontier of brain research, neurologist Dr. Helen Mayberg had recently made an astonishing discovery with the aid of brain imaging.
NARRATION: (DR. HELEN MAYBERG AT DESK WITH IMAGES OF BRAIN SCANS) Mayberg already knew that every depressed patient's brain looked different. There seemed to be no consistent pattern among them.
NARRATION: (DR. HELEN MAYBERG AT DESK WITH IMAGES OF BRAIN SCANS) she also knew that
NARRATION: (PET SCAN FOOTAGE) most patients showed a decrease in activity in the frontal lobe, the brain's command center.
NARRATION: (ANIMATION OF A PET SCAN, IDENTIFYING AREA 25 IN RED, THEN WITH THE WORDS, "AREA 25" - #7) But she noticed that in the scans of patients who had recovered from depression, a tiny unmapped region of the brain called area 25 showed a consistent decrease in activity from a previously elevated state.
DR. HELEN MAYBERG: (OC) what you could see across the various imaging studies, at least to my mind looking at the data, was what had to happen to get well across all of these very different kinds of treatment was turning down that activity in area 25.
NARRATION: (ANIMATION - 3D #8) Area 25 sits at a critical intersection in the brain with pivotal connections to other regions involved in mood, sleep, motivation and drive.
DR. HELEN MAYBERG: (VO, ANIMATION - 3D #8) This brain area is like it's at the core of all things. It's sitting in a place that
DR. HELEN MAYBERG: (OC) when it goes wrong, havoc is wreaked.
NARRATION: (ANIMATION - 3D - #9) When patients recovered, Dr. Mayberg noticed that not only did area 25's activity cool off, but the frontal cortex's activity picked up.
DR. HELEN MAYBERG: (VO, ANIMATION - 3D - #9) The decrease in 25 trapped with increase in frontal cortex...it's like they were linked.
DR. HELEN MAYBERG: (VO, EXPLAINING IN FRONT OF COMPUTER IN DARK ROOM) And this was one of our earliest clues about...thinking about a system rather then any one brain area in isolation.
NARRATION: (DR. MAYBERG IN FRONT OF COMPUTER) In an effort to pinpoint where moods occur in the brain, Dr. Mayberg conducted an experiment. She asked healthy volunteers to ponder sad thoughts
What she found was that the same system lit up. Area 25 became overactive while the frontal cortex quieted down.
NARRATION: (DR. HELEN MAYBERG WALKING DOWN HALL) But while healthy volunteers could bounce back quickly from their sad state, depressed patients could not.
DR. HELEN MAYBERG: (VO, DR. MAYBERG WALKING DOWN HALL) And I always say, the machinery is in a state, the software is in a-- is in a bad loop.
DR. HELEN MAYBERG: (OC) This is emotion stuck. This is sadness unbreakable.
(I think this idea of going back to...)
NARRATION: (DR. HELEN MAYBERG IN STAFF MEETING) To Dr. Mayberg, the illness of depression was looking like a circuit board failure.
So, she decided to surgically target area 25 in patients like Deanna, with the hope of resetting the brain's rhythm.
DR. HELEN MAYBERG: (VO, IN STAFF MEETING) If you can't talk it down, drug it down,
DR. HELEN MAYBERG: (OC) shock it down, maybe you have to do something else in a much more precise, much more bulleted kind of way, if you will.
DR. HELEN MAYBERG: (VO, IN OPERATING ROOM, MEETING WITH SURGICAL STAFF AROUND COMPUTER SCREEN) There you've got a really, kind of picture perfect view of the left side. That is the spot...
NARRATION: (IN OR DURING DBS) adapting a technique from the treatment of Parkinson's disease called deep brain stimulation, Dr. Mayberg's team is today treating a patient in a clinical trial at Emory University.
DR. HELEN MAYBERG: VO (ON LEFT SIDE OF PATIENT IN OR) Just kind of register how you're feeling right now and all those things. And if anything changes you let me know.
NARRATION: (IN OR DURING DBS) Threading two electrodes into the brain, the doctors plan to stimulate area 25 with a steady, low dose of electricity from a pulse generator, similar in c0ncept to a pacemaker.
DR. HELEN MAYBERG: (VO, MAYBERG TESTING PATIENT, WITH SURGICAL STAFF OBSERVING) Ready, go. You were fast again. Are you actually aware that your speed has been changing?
NARRATION: (VO, DR. MAYBERG AND STAFF IN OR DURING DBS) in many patients, subtle but clear changes, including improved motor skills, are immediately noticed in the operating room.
DR. HELEN MAYBERG: (VO, ON LEFT SIDE OF PATIENT IN OR) Have you been having this sensation at different settings where there is a change in the apparent...
PATIENT: (LAYING ON TABLE MID-SURGERY) Occasionally I have noticed the room gets lighter. It's almost instantaneously lighter, but not instantaneously darker.
NARRATION: (LOOKING THROUGH DOOR OF OPERATING ROOM) Deanna also experienced immediate changes in the operating room.
DEANNA COLE BENJAMIN: (VO, LOOKING THROUGH DOOR OF OPERATING ROOM) I was looking at Dr. Mayberg, and
DEANNA COLE BENJAMIN: (OC) all of a sudden I felt that connection that I hadn't felt in over four years...
NARRATION: (DEANNA BENJAMIN-COLE AT DINNER TABLE WITH FAMILY) It is as if the brain has been jumpstarted back to life, then allowing patients to do the hard work of reclaiming their lives.
DEANNA COLE BENJAMIN: (VO, DEANNA BENJAMIN-COLE AT DINNER TABLE WITH FAMILY) The surgery was, for me, one of the obviously best things, you know, best outcomes. Um,
DEANNA COLE BENJAMIN: (OC) but it doesn't change who I am innately. It doesn't make me a more happy person. It-It just helped fight through the depression.
NARRATION: (DEANNA BENJAMIN-COLE AT DINNER TABLE WITH FAMILY) Like many heart patients, Deanna now lives with a pulse generator implanted in her chest.
But, as she explains to people who ask, it does more than just stimulate her brain.
DEANNA COLE BENJAMIN: (VO, DEANNA BENJAMIN-COLE AT DINNER TABLE WITH FAMILY) And I will say that: "Oh, it's a pacemaker, um,
DEANNA COLE BENJAMIN: (OC) to help my brain function properly, not my heart." Um, but I guess in a way it does help your heart, too, because it makes your heart feel right, mm-hm.
NARRATION: (DEANNA BENJAMIN-COLE AT TABLE WITH DAUGHTER) To date, more than fifty five percent of patients participating in this highly experimental treatment have experienced a dramatic improvement in their symptoms.
DEANNA COLE BENJAMIN: (VO, DEANNA BENJAMIN-COLE AT TABLE WITH DAUGHTER) Helen gave me that chance to-- to live again, to--
DEANNA COLE BENJAMIN: (OC) to be-- to be me. And that is a real-- real gift.
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