The Dr. Oz Show
Airdate: January 25, 2012
The Truth Behind Shock Therapy for Depression
- Is shock therapy a viable treatment for depression?
- Which organ could be contributing to fatigue?
- The best carbohydrates to support weight loss
- Chef Rocco DiSpirito shares an energy boosting meal
Could the radical treatment of shock therapy be making a come back for the treatment of depression? Patients who have received the treatment say shock therapy was the only way they were able to overcome depression. They even say it saved their lives. Shock therapy is still controversial and it is still happening behind closed doors. It's radical and misunderstood. Learn about the new world of shock therapy and why patients say it has saved their lives.
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Shock therapy was first introduced in the 1930's. Back then, the procedure was barbaric. Patients were conscience during the procedure, voltage high electricity was used often leaving them with broken bones and brain damage from the strength of the resulting seizure.
What used to be called shock therapy is now called Electroconvulsive Therapy (ECT) and 100,000 are having the procedure each year.
Julie shared her story of deep depression. She says she couldn't feel or connect with people and felt like a ghost in her body. She was suicidal, attempting to take her life a total of three times. He husband found her on the first attempt. From there, she went through a variety of pharmaceuticals, psychotherapy, and even checked into a rehabilitation center. Nothing helped her, she still wanted to take her own life. Julie's psychiatrist recommended the treatment and she went through it five years ago.
Immediately after receiving ECT, Julie says she looked out the window and wanted to go outside and enjoy the day – something she wouldn't have even noticed before the procedure. She says ECT caused a powerful, positive change in her going from being suicidal to appreciating her life.
Keith Ablow, MD, Psychiatrist explains that today's ECT induces a seizure in the brain that seems to reset the chemical receptors and/or messengers in the brain that can give patients their lives back.
Today, anesthesia and a muscle relaxer is given to the patient. There are side-effects with the main one being possible memory loss around the time of the procedures. However, this is one treatment where there are few side effects. Dr. Ablow says ECT should should be used more as it has been found to be up to 80% effective. Historically, this was true as well and shock therapy has been used as the clinical standard against which all other treatments were measured.
Who is a Candidate for ECT?
Dr. Ablow says that candidates for ECT are people who need a rapid on-set of medications, who are considering suicide, experiencing delusions and thought changes, and who are not benefiting from one or more anti-depressants.
People who fall within these areas should talk to a/their psychiatrist for more information. Beyond ECT, there are other therapies that could be appropriate, as determined by a psychiatrist, such as Magnetic Wave Therapy or RTMS, says Dr. Ablow.
Psychiatrists should be telling their patients, explains Dr. Ablow, who are taking multiple medications and showing low results about ECT. The cost of the procedure is covered by most insurance companies.
How ECT Works
ECT is often an out-patient procedure, but can be preformed as in-patient. Patients are put under anesthesia for 5-10 minutes and have a short electrical pulse administered. The procedure is given as much as 6-12 times in as many visits. Compared to a life of chronic depression or someone killing themselves, says Dr. Ablow, ECT can help many people if used appropriately.
Dr. Oz demonstrated the procedure of ECT so that viewers could appreciate why this might work when done appropriately. He brought out a tissue sample of a brain and show where the two probes are placed on the head and the shock is administered.
To further explain, Dr. Oz showed an animation of a brain experiencing depression. In a normal brain, junctions between neurons in the brain received messages and release hormones, serotonin and dopamine, in response. In a brain with depression, those messages are over-active and the neurons can't keep up. The end result is a shriveled neuron junction and little to no hormones being released.
When ECT is administered it can help to resets all the neurons and connections in the brain so they can, once again, function normally.
Guest number two in favor of ECT was Dr. Sarah Hollingsworth [Lisanby, MD, Professor and Chair, Department of Psychiatry and Behavioral Sciences, Director, Brain Stimulation and Neurophysiology Center, Duke University School of Medicine].
Dr. Hollingsworth explained that early shock therapy used the same amount and type of electricity that
flows from a plug. Today's ECT uses brief pulses of electricity that is more subdued. The possible side-effects of potential memory loss can be limited with a unilateral application and short pulses of electricity, making memory loss rare.
Julie says that she is happy now and maintains her health program, What she's calls her Top 6 of Staying Well. Julie shared that she still takes an antidepressant and makes it a priority to protect her routines around sleep, exercise, and nutrition.
To people considering ECT as an option in treating depression, Julie recommends being aware of the risks involved and to have an advocate with you throughout the process, someone who will speak up for and support you. If a psychiatrist is recommending ECT then really considering it can be life saving.
Dr. Hollingsworth explains that the ECT program at Duke University is robust. She sees brain stimulation therapy as continuing to grow as a real option when medications and psychotherapy don't work.
Patient Takes Cameras Into Their ECT Treatment
Susan experienced mental illness in her 20's, what then was called a nervous breakdown. Medications didn't work. Back then, in the late 1960's and early 1970's, the treatment was much different, brutal. Susan went through six shock therapies and started medications. Two years later she had the shock therapy again. From there she able to keep the depression at bay with medications for 40 years. Until 18 months ago.
Last summer, Susan began to experience severe depression, again. Her daughter, a social workers saw her mom go away. Susan specifically asked for ECT this time around.
Dr. Oz cameras followed her into the hospital to film her her 19th treatment. Doctors administered a short-acting anesthetic and a muscle relaxant. Probes were attached to Susan's forehead to monitor her vitals statistics, she was also hooked up to an EKG to monitor the behavior of her heart.
Electric probes were placed on the top and side of Susan's head an a brief electrical pulse was given, 3-6 seconds. Susan then experienced what her doctor called a therapeutic seizure that had the potential to last 15-90 seconds. And that's it, quick. Susan was wheeled into the recovery room where she soon woke up. Susan's daughter says that Susan typically wakes quickly and is ready to go home. Her doctors keep her in recover for an unspecified time to monitor her condition and then she is sent home. Within an hour of returning home, her daughter explains, Susan is herself and goes on with her daily life.
After the electrical pulse was administered, the camera showed Susan's feet and legs twitching. Susan's doctor, Dr. Roberto Estrada, MD, Chief of ECT at Lenox Hill Hospital, explained that for most patients there are no physical signs visible. The muscle relaxer administered along with the anesthesia keeps the muscles calm and prevents the massive physical reactions that caused injury to patients in previous decades.
Dr. Estrada says that most patients do not themselves recognize any memory loss. Susan's daughter agrees, saying that her mom doesn't show any signs of memory loss. She is sometimes at a loss for a word but that could be attributed to age and not the procedure.
Dr. Ablow said that ECT has a stigma associated with the procedures from the early decades of its use. It has a bad wrap which is unfortunate because, he explains, ECT has provided a huge benefit to those who have gone through it, even saved lives.
The Organ That Could Be Causing Fatigue
Could the lungs be making you tired? Tina Knowles, designer and mother of famed singer Beyonce, joined Dr. Oz on stage. Ms. Knowles said that as a clothing designer she works long hours and finds that she feels tired all the time. Dr. Oz says her lungs could be contributing to her fatigue.
Dr. Oz demonstrated how the muscles around the lungs do the work to expand and contract along with the movements of the lungs. The diaphragm rises and lowers with each breath. We take in, on average, ½ liter of air with each breath. [If these muscles are not fit and working to their fullest, we do not experience the necessary amount air coming in to provide energy nor the releasing the amount of air necessary to remove waste which can clog our systems.]
With a tissue sample, Dr. Oz showed Ms. Knowles and the audience how infections and emphysema can change the texture of the delicate lung tissue. Turning the lung over, Dr. Oz showed areas of dark black which he said was caused by air pollution.
How do you know if your lungs are fatiguing you or not? Dr. Oz says there's an easy test to determine if your lungs are doing their job. Every year on your birthday, have at least 10 candles on the cake and stand about one foot away from the cake. Take a big breath and blow out the candles. The number of candles you are able to blow out will help give an idea of your lung strength. Dr. Oz says he gets nervous if a person can only blow out one or two candles.
Solutions to Increase Lung Function
To work out the muscles associated with breathing and to increase lung function, Dr. Oz says to blow up a balloon in the morning. Get a balloon, take one deep breath, blow up the balloon. The exercise will work the tiny air sacs called in the lungs, called alveoli, and force you to exhale and strengthen the lungs and muscles surrounding them.
Dr. Oz also wants people to roll up the windows when driving, especially at night. Air pollution can damage the lungs, as seen the tissue sample, and night time air is the worst for pollution.
Best Carbs to Drop a Dress Size
Can dropping a dress size be as easy as eating the right carbohydrates? Dr. Oz says so!
Best Carb #1: Shirataki Noodles
Shirataki noodles are made from the root of yams [and tofu] and come in at 10 calories per serving, compared to 200 calories for regular noodles. The noodles don't have a taste on their own but absorb the flavor of any thing it is cooked with. If you like pasta then this could be a smart substitute. Dr. Oz says that but swapping out regular noodles with Shirataki noodles could help you to lose 11 pounds in one year.
Best Carb #2: Purple Potatoes
Purple potatoes contain flavonoids from the sun and studies show that eating them will not contribute to weight gain. [So if I eat 2 pounds of purple potatoes per day along with the rest of my food then I'll never gain weight? Eat sugar all day along with purple potatoes and I won't lose weight? Grain of salt, people, grain of salt.]
Purple potatoes can be cooked any way you would cook regular [or russet] potatoes, except french fried. Eating purple potatoes instead of regular, says Dr. Oz, can help you to lose 3 pounds per year.
Best Carb #3: Pearled Barley
The fiber in pearled barley will help keep you full and promotes regularity. Use pearled barley in place of rice a couple of times per week and, Dr. Oz says, you'll lose 3 pounds in a year.
Best Carb #4: Pretzels
Pretzels are 50 calories less than potato chips, serving for serving. Swapping potato chips in favor of thin pretzels can help you lose as much as 6 pounds a year, according to Dr. Oz. He says that you can drop an additional pound per year by going for whole wheat pretzels. Stay away from the big pretzel rods because they have higher calories.
Fight Fatigue with Enchiladas
Chef Rocco DiSpirito, author of Now Eat This! Diet: Lose Up to 10 Pounds in Just 2 Weeks Eating 6 Meals a Day!, shares his recipe for Rocco DiSpirito’s Cheesy Turkey Enchiladas With Tomatillo Salsa and Cilantro to help boost energy.
With 38g of protein from turkey and black beans, or use 98% lean ground beef in place of turkey, along with low-carb tortillas made with flax seeds, this meal will keep you full and balanced. The enchiladas come in around 300 calories, including a salad.
Dr. Oz recommends to boost energy with astragalus, 200mg twice a day, to fight stress related to fatigue.
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