Does Brain Stimulation Work Better Than Medication?

This video is about the devices and procedures we use in psychiatry to treat certain illnesses. We call these neuromodulation devices. There are called this because they work by directly stimulating the brain to get their effect. The devices or procedures I’m talking about today are transcranial magnetic stimulation or TMS, electroconvulsive therapy or ECT, vagus nerve stimulation or VNS, neurofeedback and trigeminal nerve stimulation system or eTNS.

Depression and Neuroplasticity video

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References
Double-Blind, Sham-Controlled, Pilot Study of Trigeminal Nerve Stimulation for Attention-Deficit/Hyperactivity Disorder

McGough, James J. et al. Journal of the American Academy of Child & Adolescent Psychiatry , Volume 58 , Issue 4 , 403 - 411.e3

Carpenter LL et al, Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of acute treatment outcomes in clinical practice. Depress Anxiety 2012;29(7):587–596

Marzbani H, Marateb HR, Mansourian M. Neurofeedback: A Comprehensive Review on System Design, Methodology and Clinical Applications. Basic Clin Neurosci. 2016;7(2):143–158.

Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.

[theresarezac]

My daughter did Nuerofeedback and it did wonders for her depression and anxiety. It’s expensive but works!!

[diablominero]

ECT is totally the brain version of "have you tried turning it off and back on again." But turning a brain off and back on again has risks because brains weren't built for that.

[pinksterbabee]

I’m going on my 6th session for direct neurofeedback for anxiety, depression/dysthymia and I’m happy to say it’s been working for me. I started to see improvements after my 3rd session (some tweaking was needed in the 2nd session) for mood, energy and just overall calmer. I’m fortunate I have work benefits that helped cover a portion of the treatment or I may not have paid past 3 treatments to not see any improvements. So happy to actually feel grateful to have some relief and hopeful for more permanent results paired with talk therapy. For those still struggling, please take my word and don’t lose hope ❤️

[FiorePeriale]

Neurofeedback changed my life. After dealing with general anxiety for many years... I was miserable and just wanted to die. Every day I thought "this is the day I'm going to end my life"... then I didn't have courage to do it, it was exhausting. Therapy and medication didn't work. I can't even explain how much my life has changed. I'm at peace now. I'm finally at ease.

[ElleMcLin]

I've had ECT treatments twice. They never worked on me, I was at the time treatment resistant to almost every medication they've treated me with. Not only was I already triggered by hormonal changes from birth, I slipped into a non-functioning postpartum depression. In out the hospital every month for a year. Was also being treated with antidepressants that caused me to be stuck in suicidal ideation. Several overdoses attempted per year for several years. ECT took my memories permanently, they did too many sessions. My Dr went on vacation before my total sessions he said no more than two more, the doctor in his place did 4 more. It never budged my mood or depression. I also have had TMS but in much less treatments than someone with unipolar depression gets. I'm aware it's not FDA approved for bipolar depression but it was a last resort experimental thing and and it was the miracle treatment to my bipolar depression until I could no longer stomach my latuda and came off of my combination that kept me stable after treatment. In 2009 or 2010 I was offered TMS as a trial and refused because of my horrible experience with ECT, had I gotten it then, I could have changed my life sooner and ended alot of years being consistent in mental he'll. My diagnosis is, bipolar 2 with ultra rapid cycling with mixed episodes, PMD, SAD, anxiety, BPD, PSTD so yes I'm very resistant to many medications and treatments. First unipolar episode onset at 9, first hypomanic episode at 15, stays in a very agonizing depressive state been in consistent treatment since age 19, also diagnosed bipolar 2 at 19, I'm currently 45. It's a miracle I'm still here.

[ramonroblesjara]

Thank you for your work making these videos. For us, people with mental disorders knowing what treatments we can have it is very important and life saving 😊

[dj]

I love that you keep us up-to-date on the latest treatments & information. Thanks so much, Dr Marks!

[yahwehskingdom]

So good to see...somebody of my color speaking on this and qualified.... we need more doctors like this in our communities to bring awarness

[leslyloumiranda]

I have a VNS to treat my epilepsy and tbh it’s great. I have depression, anxiety, bipolar disorder and borderline personality disorder. Since having my first one implanted in 2015 my epilepsy has gotten a lot better. I went from having seizures a couple times a month to being seizure free for two years next month. Now, with my depression it has made a HUGE improvement because my seizures are triggered by emotional stress. Since I don’t have much emotional stress anymore, I DONT GET SEIZURES!! I love it.

[schulzfive]

My 19 year old daughter is doing neurofeedback and we’re seeing positive results. She’s much calmer (it helps with ADHD) and happier. She has weaned off one of her depression medications and is doing amazing! I’m starting to see her sense of humor return and her desire to get up early and be more productive. We prepaid for 40 sessions, so yes, it’s costly, but the benefits are outweighing any cost - and are permanent. There are lots of studies out there that affirm is effectiveness.

[Amanda-ilks]

I underwent 12 sessions of ECT in late 2017 for major depression (9 unilateral ultra brief & 3 bilateral brief pulse). They stopped administering it when I didn’t know my treating doctor. All it did is leave me with 3 months of memory loss which remains & executive function deficit. It is completely barbaric & I would argue that the neurogenisis & increased blood flow seen post treatment is due to brain damage. Never again!

[GoogleAccount-oeim]

Fantastic video — as always!! Thank you for your valuable insight! You’re a medical QUEEN

[annac.]

I've been having ECT for over a year and a half now for severe treatment resistant depression and it has saved my life. TMS was not effective, although that could have been because my depression continued to advance and I ended up requiring hospitalization. I still take effexor and abilify and I do best if the ECT is every 4 weeks. Thank you for your videos; They are so informative.

[dogmonday]

I have been wanting to know about neurofeedback for a while and this helps. I have bp2 disorder, and I would just love to be cured of it. But it seems like all there is to do is just learn to manage it. Similar to all mental health problems. I don’t understand why there is so much stigma with mental health. the brain is a powerful organ, and it’s more glamorous than cardiac function for sure. With mental health we blame the victim, like it is some form of moral defect. Dr Marks thank you for these videos. I really enjoy them and feel they have helped me tremendously. Many thanks. Susan

[dreww]

Thanks for sharing this video, Dr. Marks. It's good to know that there are alternatives offered to regular medications that are usually prescribed. It would be great if you might be able to cover the PONS device offered by Helius corporation. This device was approved in Canada for use for balance/gait issues, however, it has been shown to be incredibly effective for PTSD, trauma, MS patients, stroke patients, speech and balance impairment along with many other benefits. The PONS device is also a neuromodulator and is non-invasive, and appears to be a device that could help so many people who are struggling with issues that affect the brain.

[jimmill]

Thankful for your videos I am bipolar too and I have PTSD and conversion disorder so when people need to know and don't understand my diagnosis I send them your videos everybody's very pleased with your explanations you do a great job of explaining really appreciate what you do for the mental health community

[boundless]

Ive done neurofeedback it helped anxiety not as much as depression in my experience.

[raumedina]

I have 7 sessions, currently I have 3, but I have not felt anything different, my memory is fine, I remember everything, the only thing is that the doctor asks me if I have taken any medication such as valium because I am very relaxed during the session, I explained No, the only bad thing is that I felt very tired, a lot of daily muscle pain but I know what the side effects are.

[nwatson]

I feel helpless and hopeless. Having a mood disorder is hell! I haven’t been consistently happy since I was 12.

[peterstanghellini]

Wow, that’s scary. Hope you see better days ahead