Going deep. But are we getting
to the roots of distress?
A recent example of such a new treatment is Deep Brain Stimulation (DBS) DBS seems to be helpful to people experiencing a range of motor-related physical problems, and is most commonly used with people experiencing Parkinson’s disease. Implantation of electronic devices to help people to overcome physical conditions seems to make sense, and qualitative explorations of the impact of DBS for people with primary dystonia (a condition characterised by involuntary muscle spasms) suggest its effects can be life-transforming.
But, there is a danger here that may come from the magnetic attraction of the shiny and new. In particular I was somewhat concerned to learn of possible mission creep for DBS. If it’s good for the difficulties above might it also help with other problems? DBS is currently being piloted for use with people experiencing emotional distress. This results from mood-related side-effects that were reported by people being treated for physical conditions with DBS. People diagnosed with depression and people diagnosed with Obsessive Compulsive Disorder (OCD) have been part of pilot trials to see whether DBS can help them. Some of the language used in the reporting of these trials seems, at the very least, detached from the human experience of depression:
‘DBS to different sites allows interfering with dysfunctional network function implicated in major depression’. (Link).
‘OCD is essentially the result of faulty wiring in the brain’. (Link)
Who decides what the correct state of mind someone should experience is? What if people felt better when nothing had apparently been changed in relation to the DBS implants: is it a result of their efforts, related to the DBS, or to something else? Given control over one’s own implants, might it become possible to become somewhat lost, chasing some idealised emotional state, unsure if what one was feeling in the present was genuine? There is an overlap here with possible interpretations people might make with medications. However, people have more control over their medications: they can often choose to stop taking them, and if they do, there is no hardware to surgically remove.
According to the National Institute of Mental Health DBS carries risks associated with any type of brain surgery. For example, the procedure may lead a number of unwanted effects including: bleeding in the brain or stroke, infection, disorientation or confusion, mood changes, movement disorders, light-headedness and trouble sleeping.
‘OCD-UK do not recommend DBS as a treatment for OCD and remain concerned that the dangers associated with the procedure continue to be overlooked by the medical community when much safer and less invasive treatments remain available.’
So when we are presented with miraculous-sounding cures, perhaps we need to exercise healthy scepticism and, whilst not automatically dismissing them, ask some relatively straightforward questions:
- On which evidence shall our decisions be based?
- In whose interests was that evidence collected and presented?
- Who stands to benefit from the treatment? This extends beyond potential recipients to the companies producing them, and the reputations of the people associated with them.
- And last but never least, do the potential benefits outweigh the risks?