While introducing the Experimental Medicine Initiative at a recent conference, Thomas Insel, the director of National Institute of Mental Health (NIMH), criticized both antidepressant medications and psychotherapy for their high rates of failure. Insel says the currently available interventions for mental illness are “woefully inadequate” and is frustrated by a “lack of progress” when it comes to developing new drugs and identifying new neural pathways to target. He believes psychiatry and psychotherapy demand the kind of rigor, precision, and high standards to which other fields of medicine are held.
Most mental health experts agree: we need new treatments, or, what Insel refers to as the “next generation of interventions.” Among veterans, this gap–the inadequacy of psychiatric medicine and mental health therapies in general–is particularly acute. For military service members, the trauma of combat and the return to civilian life often triggers stress, and further exacerbates existing mental health issues. Veterans are especially vulnerable to psychological dysfunction arising out of traumatic brain injury (TBI), post-traumatic stress (PTS), and depression.
All too often, bureaucratic red tape impedes the efforts of veterans who do attempt to access healthcare services. But, if current psychological treatments are “woefully inadequate,” as Insel says, is there hope for people who suffer from depression, PTSD, or other forms of neurological dysfunction?
Fortunately, there are reasons to be cautiously optimistic. Although our understanding of psychiatry and neuroscience lags in comparison to scientists’ knowledge in other areas medicine, researchers have made new strides in treating mental illness. These discoveries could lead to new treatment options, offering hope for the future of mental health care.
Transcranial Magnetic Stimulation (TMS, or rTMS) – Transcranial Magnetic Stimulation works in a manner not unlike electroshock therapy, but the TMS procedure isn’t invasive and doesn’t cause cognitive side effects that are often associated with electroshock, such as memory impairment. During TMS treatments, a practitioner administers a magnetic current along the patient’s scalp. The procedure isn’t painful and during treatments, patients remain conscious. Studies, including one by the National Institute of Mental Health (NIMH), have demonstrated its efficacy and safety in treating major depression.
Magnetic Seizure Therapy (MST) – Magnetic seizure therapy (MST) borrows certain aspects from both Electroconvulsive Therapy (ECT) and rTMS. Like rTMS, MST employs magnetic pulses. And similar to ECT, patients undergoing MST experience a seizure. MST is still in the early stages of testing for mental disorders, but researchers believe their initial results are promising.
Ketamine – Ketamine is approved by the FDA as an anesthetic, and in just the right doses, it causes hallucinatory and out-of-body experiences (which makes it a popular club drug). Multiple studies have shown that 24 hours after receiving a single infusion of IV-administered ketamine, the severity of PTSD and depressive symptoms in patients with chronic PTSD was significantly reduced compared to those who received an active placebo. The therapeutic benefits of traditional antidepressants, meanwhile, often take four to six weeks to take effect. Because many people who suffer from clinical depression and/or PTSD do not respond to antidepressants, scientists think ketamine research looks promising.