: what does somebody's life look like? Who is suffering with severe depression? You know Kyle. I don't think that. Well, let's just say this: unless you have experienced this or experienced it with a loved one, I don't think the general population knows what true severe depression looks like or what true treatment-resistant depression looks like I'm, so glad you're saying you know this what's so so important Is that I still to this day, get people when I bring up depression or when, when people read stuff like? Oh, my god, the CDC is saying that this is it one of the largest disabilities in the country. People like what they're depressed they're sad get over it and when people are profoundly depressed Kyle, when people have treatment-resistant depression, if they are non-functional, it's as if their brain and then secondarily their body shuts down, they can't function.
Mm-Hmm, I'm telling you they. I have patients with severe treatment-resistant depression that don't talk mmm, and these are people who are educated and held a job and have a family. They stop speaking, they won't get dressed, they won't eat, they won't shower, they won't bathe and they're. Not being stubborn, They they don't have it. They have no motivation, they have no desire to get. Why would you be stubborn on living a life like that? Okay, you don't want that. It'S they completely shut down. It'S as if their brain and body flat lines in this helpless, hopeless, dark place, mm-hmm that is true, treatment-resistant depression. It'S important that we make that distinction. This isn't just feeling blue or having a bad day right right so for people who get diagnosed with depression before it reaches to the point where they're not talking. For example, many psychiatrists will recommend or use SSRIs to treat that depression from a very high-level standpoint. What is an SSRI and how is it used? The SSRIs are probably the first-line treatment with psychotherapy first-line treatment for a depressive episode.
So once once someone gets a diagnosis of a major depressive episode after an evaluation by psychologist or psychiatrist, you'll start on an SSRI, which is a very basic antidepressant medicine. The good news is is that they work fairly well and they have minimal side effects for the most part and they're tolerated really well right, um, but the problem with them is that only about 50 % of people respond right. So, if you're really going through a hard time in your life and you're having a severe depressive episode and you take an antidepressant - you have a 50/50 shot of it. Really working.
Those aren't really good odds mm-hmm, you know. So if those SSRIs aren't working, the depression continues to get worse and worse you're. Now at this damn at this point, where you're in a treatment resistant depression, why is ECT different? How does it work differently? So this is we're gon na get into the history of ECT, and when you talk about the neuroscience behind ECT but Kyle, this is something where the treatment preceded the understanding of it, which means that in the 1930s neuroscientists realized that when people had a seizure, whether It was from an epilepsy or whether it was from an induced from a fever or from a medication if they realized that it cleared up some mood problems that they had after a seizure.
So there was this correlation that was made that something is going on when the brain has a seizure. That equates a relief in psychiatric disturbance. That'S where it all started, got it now. You know a lot more about the brain, thankfully, and at this point we realized that when the brain has a seizure, your neurons are firing. What happens? It'S like a domino effect, your neurons start firing and they just take over the entire brain and they all fire and when those neurons fire they are all communicating and secreting neurotransmitters. So, to put it very basically, it's like industrial-strength antidepressant, because the chemicals that you're increasing with an antidepressant an SSRI, we talked about norepinephrine, serotonin, dopamine,
All of these you're flooding your brain with these, and now science has really looked into what is happening when you induce a seizure and we're seeing very similar results. That would happen with an effective SSRI, but it would take 6 8 12 weeks. We'Re seeing in ECT can happen within six seven. Eight and those are. We see, changes in the brain structure, we're actually seeing neurogenesis in certain parts of the brain, and this is similar to a lot of psychiatric treatments that help depression. We see hypo Campbell volume increase. We see parts of the brain that are affected by depression, the prefrontal cortex sprouting new neurons and fibers right, so you're, basically getting an industrial-strength flood of neurotransmitters and some neurogenesis Wow, okay, two questions: who is this series for and what will people get out of this Series this series is for basically anyone that thinks. Still, oh, my god, ect is Jack Nicholson in One Flew Over the Cuckoo's Nest right, so we're gon na clear that up, right, yeah, yeah, alright and more importantly, people that have treatment-resistant depression really want to know.
All of the options, people that have a loved one, that has treatment, resistant depression and just really wants to know what's out there, what are my treatment options? Ect is one of them. It'S not the only one right. There are many others that we've talked about and we'll mention today just so. Everyone is a very well-rounded understanding, but these are the fda-approved. Will ect is fda-approved, it's it's a viable treatment option that actually does work and it's actually really safe now. So this is all about education yeah, whether it's for helping a loved one, helping yourself or just providing yourself with a good understanding of what is out there in the psychiatric world. Thanks for watching, if you like what you just saw, then why not subscribe click right here for new episodes, a new series every week and to access exclusive mental health videos that we only release at Med circle com check out the links below you, ,