PSY230H1 Lecture Notes - Lecture 10: Transcranial Magnetic Stimulation, Seasonal Affective Disorder, Deep Brain Stimulation
Week 10 – Wednesday March 30th, 2016
Biological Therapies
• Early biological treatments
o Bloodletting
• Have a headache? Bleed out a little bit and you'll be fine!
o Trephination
• Drill a hole in the skull to release pressure
• Laid the foundation for psychosurgery
o Psychosurgery
• Destruction of specific region(s) of the brain
• Developed during era of brain-behaviour correlations
• Eventually discredited
• Transorbital frontal lobotomy
▪ Ice pick up the eye and sweep the frontal cortex?
▪ The treatment was worse than the disease
• Current psychosurgery procedures
▪ Ethical debate in 1960s - 1970s
• Inmates offered psychosurgery but they couldn't give consent?
▪ Psychosurgery as tool of control discredited (1974)
▪ Limited procedures permitted (used nowadays but very regulated)
• Subcaudate tractotomy
• Lesions in the frontal lobes to structures like the amygdala
• Limbic leukotomy
• Lesions administered to the interior cingulotomy
• Anterior cingulotomy
• Anterior capsulotomy
o Electroconvulsive therapy (ECT)
• 100 volts causing seizures
• Bilaterally or unilaterally
• Developed in 1930s to treat schizophrenia
▪ No longer used for schizophrenia
• Currently used to treat severe depression
• History of adverse side effects
• Little research on long-term effects
• Still utilized but less frequently - last resort for depression
o Other early treatments
• Insulin shock/coma therapy
▪ Developed by mistake - insulin overdose that induced coma and when
patient woke up from coma, no longer had opioid addiction
▪ Dangerous - 1-2% of people die
• Hydrotherapy
▪ Emerged in water
▪ Lethargic patients receiving stimulating sprays of painful water jets?
▪ Some spending hours and hours in hot water
▪ Some wrapped in towels in ice cold water
• Psychopharmacology
o Psychoactive/psychotropic medications
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• Any substance that affects psychological states and functioning
o Commonly used
o Often safe and effective
• Side effects
o Provides relief, but not cure the disorder or cause of illness
o Long treatment duration is common
• Years long
• For some illnesses like schizophrenia
o Prescribed by MDs
o
• No classes of drugs are effective for all individuals
o Should be used in combination with other treatments to prevent relapse
• Deep brain stimulation
o Electrodes target specific brain regions
o For treatment-resistant disorders
• OCD, Parkinson's, depression?
o Effects seem to be reversible
• Unlike lesioning the brain
o Mechanisms unclear
• Maybe affects neurotransmission
o Side effects
• Headaches
• Can induce depression
• Gambling
• Hallucinations
• Side effects might be related to the exact placement of the stimulators
▪ Might only be a temporary effect
• Repetitive transcranial magnetic stimulation (rTMS)
o Magnetic pulses --> cerebral electrical activity
o Great therapeutic potential
• Highly customizable
• Pulses may elicit desired effects
• Seems to be good for depression, positive symptoms of schizophrenia
• Magnetic seizure therapy
o Magnetic pulses --> seizures (like ECT)
• These are focal seizures (like the size of a golf ball) whereas ECT affects the
whole brain
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o Fewer side effects
• No memory loss like in ECT
• Side effects seem to be limited to the ones associated with the anesthesia (like
nausea and headaches)
o Research looking to use this to treat depression
o Suppression of brain activity after the seizures (seems to be caused by GABA)
• Prevent negative thoughts from flooding brain
• Light therapy
o Exposure to artificial non-UV light
• For a certain amount of time, usually first thing in the morning
o May impact circadian rhythms
o Useful for seasonal depression (some studies say it helps non-seasonal depression
too)
• Less light in autumn and winter
• But a recent study just came out saying that depression isn't associated with
season/amount of light
▪ No such thing as seasonal depression?
▪ Might just have to do with sleep (circadian rhythm)
o Some research has shown that it's as effective as some medications
o Inexpensive
Psychotherapy
• Systematic use of techniques
• One on one
• Derived from psychological principles
• Intended to relieve distress, reduce impairment, or facilitate growth
• Classical psychoanalytic and psychodynamic approaches
o The structure of personality
• Freud said that the point of the unconscious is to protect us from anxiety
• The id - the demanding child
▪ Ruled by the pleasure principle
▪ Instinctual needs to reduce tension, relieve pain, and gain pleasure
• The ego - the traffic cop
▪ Ruled by the reality principle
▪ Mediator
• The superego - the judge
▪ Ruled by the moral principle
▪ Strives for perfection, not pleasure
o The development of personality (AKA psychosexual stages)
• Oral stage (birth - 18 months)
▪ Can become fixated
• Anal stage (18 months - 3 years)
▪ Anal retentive - parents have high expectations and strict during potty
training
• Grow up to be very … anal
▪ Anal expulsive - parents too lax
• Grow up to be a disorganized mess all over the place
• Phallic stage (3 - 6 years)
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