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CES and the Treatment of Depression and Anxiety
Depression
Depression is the state in which the individual feels sad, helpless, and
disinterested in life. Clinical depression affects mood, mind, body, and
behavior. Depression is the most frequently seen psychiatric disorder
among both hospitalized inpatients and those in outpatient psychiatric
care. Research has shown that in the United States about 19 million
people-one in ten adults-experience depression each year, and nearly
two-thirds do not get the help they need.
There are many kinds of depression, several with deep underlying
psychiatric causes. Short of biochemical analysis, however, they are
usually difficult to differentiate. Psychological testing can rate
depressive states according to intensity but cannot differentiate
causative factors. Despite the variations in etiology of depressive
states, however, treatments are very similar.
Context
Five studies employing three different measures and 189 different patients
suffering from depression. All were in treatment facilities, either
psychiatric or chemical dependency. Each of the studies was conducted
under controlled conditions; one, double-blind, four, single-blind.
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Graphical Interpretation
Under each set of bars is the psychological test used to measure
depression in each study including a general average of all results.
The red bar shows patients' scores before using CES-the higher the
bar, the greater the depression. The blue bar shows the level of
depression after using CES. |
Results
There have been three replications of findings on the Profile of Mood
States, Depression-Dejection factor, and two replications using the Zung
Self-rating Depression Scale (POMS-D and ZSDS, respectively on the graph).
All yielded similar results. The movement on the ZSDS scale is less
because one study was for one week and the second, for ten days. The
studies which ran over a span of three weeks, however, provide evidence of
an even more dramatic decline in depression.
All three tests yielded congruent results-an average reduction of
approximately 50% in the depression raw scores measured before and after
CES treatment. All types of depression responded dramatically to CES. CES
showed itself to be effective in treating the lighter reactive type within
a week or ten days and the deeper seated variety in three weeks.
Because those with deep-seated depression tend to view CES as a modern
"miracle," and expect instantaneous relief, they can actually become more
depressed initially while using CES unless the therapist specifically
tells them that at least three weeks of treatment are required. With this
added clinical support, even the most deep-seated depressions responded
well. The study controlled for possible placebo effects did not show any.
There has never been a reduction in the scores of sham CES treated
controls.
As in the anxiety studies, while some depression studies were "sacrificed"
in the attempt to discover how much treatment was necessary to correct the
various intensities of depression, there has never been a controlled
scientific study in which CES was not shown to significantly improve
reactive depression in a week to ten days and deep seated depression
within three weeks. All types of depression studied so far, have responded
dramatically to CES treatment.
Anxiety
Introduction Anxiety is defined as "mental
uneasiness" or "distress arising from fear of what may happen." It has
several different manifestations. Individuals suffering from panic
disorder experience recurrent, unexpected panic attacks. Those with
generalized anxiety disorder (GAD) chronically worry too much about a
variety of things, and experience symptoms such as restlessness,
agitation, or feeling keyed up, muscle tension, fatigue, irritability, and
trouble with concentration and sleep. Persons suffering from social
anxiety disorder experience extreme fear and avoidance of social and/or
performance situations.
Anxiety disorders, as a group, are the most common mental illness in
America. More than 19 million American adults are affected by these
debilitating illnesses each year. Children and adolescents can also
develop anxiety disorders. Anxiety is currently perhaps the most
fashionable idiom in the parlance of American psychiatry and medicine. It
is used almost synonymously with stress which in turn has been associated
with everything from increased risk of heart attack and cancer to the
common cold. The general consensus within the medical community is that
anxiety can in many instances, be a causative factor in physical illness
as well as exacerbate it.
Context Seven separate studies of 220 hospitalized psychiatric
inpatients. All were controlled scientific studies employing measures of
anxiety with known reliability and validity. There are four replications
using the state anxiety scale ( STAI-S) and three using the
tension/anxiety factor on the Profile of Mood States ( POMS-T/A). Most of
the studies were for fifteen days-Monday through Friday over a period of
three weeks. The TMAS ( Taylor Manifest Anxiety Scale) was for ten days
only, and one of the IPAT ( Institute for Personality and Ability Testing)
Anxiety Scale. Studies, for only six days. Studies using the STAI-S used
five or six thirty minute sessions whereas one of the POM-T/A studies used
CES for thirty minutes a day over ten days and two others at a rate of one
forty minute session per day for fifteen days.
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Graphical
Interpretation
The red bar represents the patients' scores on the anxiety measure
before CES treatment (PRE); the blue bar, their score after CES
therapy (POST). |
Results
The findings of all tests conducted were consistent: Most patients
responded positively to CES treatment within the first week or ten days;
the more entrenched forms of anxiety, within ten days to three weeks.
Resultant post CES test scores shows improvement ranging from
approximately 30 percent to almost 65 percent. The variation was due to
different anxiety scales measuring different facets of anxiety, only some
of which are shared in common. In one study, investigators deliberately
used patients with low suggestibility levels and compared them with those
with high suggestibility levels. No differences were found, thus ruing out
a placebo effect.
The net result of these studies shows CES to be a predictably effective
treatment for anxiety and related disorders as measured by these scales.
There has never been a controlled study of anxiety in which CES patients
did not improve more significantly than did the controls.
Most Recent Studies
Braverman, E, Smith, R., Smayda, R, and Blum, K. Modification of P300
amplitude and other electrophysiological parameters of drug abuse by
cranial electrical stimulation. Current Therapeutic Research.
48(4):586-596, 1990.
P300 waves have a reduced amplitude in many alcoholics, which does not
revert to normal, even after continued abstinence. 13 alcohol and/or drug
abusers and 2 staff controls were selected as they entered the clinic for
a computerized EEG. All were given 40 minutes of CES between pre and post
EEG. There were no significant changes in the controls. Following the CES
the patient's P300 amplitude increased significantly (P<.05). The time
went from a pretreatment of 308 to 317 msec post-treatment. The amplitude
(dV) sent from pretreatment of 7.0 to 9.9 post-treatment. Also there were
significant positive shifts in alpha, delta, theta and beta spectra in
patients who were abnormal in one or more of these areas prior to CES
treatment. It was concluded that CES might be a significant non-drug
treatment for the underlying electrophysiological disorder of the drug
abuser, because the normalization of these electrophysiological parameters
are characteristic of pharmaceutical treatment.
Klawansky S, Yeung A, Berkey C, Shah N, Phan H, Chalmers TC., Department
of Health Policy and Management, Harvard School of Public Health, Boston,
Massachusetts 02115, USA. Meta-analysis of randomized controlled trials of
cranial electrostimulation. Efficacy in treating selected psychological
and physiological conditions. J Nerv Ment Dis. 1997 Dec; 185 (12): 766-7
Researchers conducted an extensive literature review of cranial
electrostimulation (CES) efficacy that identified 18 of the most carefully
conducted randomized controlled trials of CES versus sham treatment. For
the 14 trials that had sufficient data, the techniques of meta-analysis
was used to pool the published results of treating each of four
conditions: anxiety (eight trials), brain dysfunction (two trials),
headache (two trials), and insomnia (two trials). Because studies utilized
different outcome measures, an effect size method was employed to
normalize measures which were then pooled across studies within each
condition. The meta-analysis of anxiety showed CES to be significantly
more effective than sham treatment (p < .05).
Shealy, C. et al, Depression: A diagnostic, neurochemical profile and
therapy with CES, J of Neuro. & Ortho. Med Surg. 10(4): 319-21, 1989.
Research was conducted with 4 groups: (1) "normal group", (2) intractable
chronic pain, (3) chronic pain with depression, and (4) longstanding
depression unresponsive to medication. Psychological tests, serotonin and
cholinesterase levels were measured pre and post. Depressed patients
improved most with treatment; 60% reported improvement, 44% of the pain
patients reported improvement. In the depressed patients, after treatment,
both serotonin and cholinesterase levels improved significantly.
Treatment of Anxiety-Schmitt, R. Capo, T. & Boyd, E. CES as a treatment
for anxiety in chemically dependent persons. Alcoholism: Clinical and
experimental Research. 10(2): 158-160, 1986.
60 substance abusers, mean age 33.9, were given
either CES (30), sham CES (10), or (20) no experimental treatment. Four
psychological measures administered pre and post. CES and sham patients
received 30 min. of treatment daily for 15 days. Treatment t-tests reveal
CES patients had significantly greater improvement in anxiety levels than
did either control group. No placebo effect noted.
CES Research in the News: The Body Electric: What is electrical brain
stimulation used for? And is it safe? Slate, By Amanda Schaffer, Jan. 11,
2005
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