Introduction
According to Professor Gin Mahli of the University of Sydney, “major depression is a common illness that severely limits psychosocial functioning and diminishes the quality of life” (Mahli 2018). Those who suffer from depression experience symptoms like feelings of unhappiness, hopelessness and discontent, loss of appetite, lack of motivation, excessive tiredness, anxiety, and irritability (Mayo Clinic 2018). Oftentimes people who have depression struggle to complete normal everyday tasks. Depression is very common with one in five people experiencing an episode of major depression in their life. Major depression was ranked as the third cause of burden of disease by the World Health Organization in 2008 and is projected to be the number one cause by 2030. Women are twice as likely to experience symptoms of depression than men, and one in every ten primary care patients report symptoms of depression. Depression can be affected by social, cultural, and economic factors; however, there are oftentimes underlying genetic causes for the disorder (Mahli 2018).
The exact causes of depression are not known for certain, however, scientists have been able to identify links to certain phenomena. One of these links is inflammation in the body via peripheral cytokines. Peripheral cytokines are part of the peripheral nervous system and are involved in cell signaling. These mechanisms can explain why those who suffer from autoimmune diseases experience depression more frequently as autoimmune diseases are inflammatory diseases. Inflammation may cause neurons in the brain to communicate less efficiently. This theory also explains why when cytokines are administered therapeutically it may trigger depression (Kruse et al. 2018).
Research Overview
Due to this, scientists from the UCLA Semel Institute for Neuroscience & Human Behavior, Cousins Center for Psychoneuroimmunology, and the Department of Neurology from the University of California at Los Angeles hypothesized that using electroconvulsive therapy would help to minimize symptoms of depression caused by peripheral cytokines that were affecting brain cognition as this therapy would help to stimulate neurons and encourage better brain function. Electroconvulsive therapy involves sending electrical currents through the brain in order to stimulate communication between neurons.
To test this, they conducted a study in 2014 (that was later published in 2018). The subjects of this particular study were patients suffering from depression. Of these patients, fourteen were men, and fifteen were women. The subjects must have had at least two major depressive episodes and must have been unresponsive to treatments from at least two types of antidepressants. During the duration of the experiment, patients were subject to blood testing four different times. The first blood test was within twenty-four hours before the first electroconvulsive therapy treatment. The second blood test was taken at the follow-up from the second treatment and the third blood test was before the third electroconvulsive therapy. The fourth blood test was taken within a week of completing the electroconvulsive therapy treatment. The time length of the total treatment lasted around four to six weeks. At each of these blood tests, there were also clinical evaluations of depression symptoms taken as well as an analysis of cytokine levels in the blood. The evaluation of depression symptoms was based on the Montgomery-Asberg Depression rating scale, which rates depression on a scale from zero to sixty. Results from this experiment show that electroconvulsive therapy was effective in treating patients with depression. The mean MADRS scoring before treatment was forty. For a person to be classified with severe depression they must score a thirty-four. By the end of the treatment, patients had a mean score of 17.5 on the MADRS scale. This score places the patients into the category of mild depression. In addition to this, it was found that those who started out with a baseline of higher levels of cytokines had more dramatic results and were more responsive to treatment. This suggests that a cause of depression is linked to inflammation and electroconvulsive therapy may prove to be the most successful treatment for those suffering from depression of this kind.
Methods Overview
It is worth noting that the sample size of this study was quite small so the data is not necessarily significant to the field of science as of yet. Along with this, the ages of the patients have not been stated as well as the social and environmental factors that affect them as well. In addition to this, the study was not able to be a double-blind study which means that bias may have affected the results from both sides. With that being said the placebo effect may be influencing the results of this study. Along with this, antidepressants were discontinued within forty-eight to seventy-two hours of the first ECT treatment. Scientists are unsure of how this tapering may have affected the results of this treatment (Kruse et al. 2018).
Conclusion
The results of this experiment show a promising future for electroconvulsive therapy. Not only this, but it encourages further research into the links between cytokines and depression. If it is proven that electroconvulsive therapy is successful in the treatment of depression doctors may take different approaches to treat the illness. If studies show that this therapy is effective it may increase the quality of life for thousands of people.
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