Concussions and mental health

The Washington Post had an interesting article yesterday that nicely sums up some of the difficulties that those with head injuries can experience.

Neurofeedback is a great way to treat concussions and other head injuries. It can begin as soon as the patient is medically stable enough to receive treatment. Of course, prevention is the best way to approach head injury, but once it has happened, neurofeedback usually provides an important element of rehabilitation and return to pre-injury function.

Causes of Depression

A couple of articles caught my eye over the last couple of days. The first one,, looks at the correlation of living at high altitude and increased rate of suicide. This particular researcher seems to think that it all comes down to changes in the metabolism of the neurotransmitter, serotonin.

I would counter that this is an oversimplification of a complex issue. It like saying cancer has a single cause when the evidence is quite well established that most cancers are caused by a complex interaction between the individual’s genome and environmental influences.

So while high altitude needs to be examined as a risk factor for committing suicide, other contributing factors must be examined. We already know that high altitude results in a change in oxygen and carbon dioxide levels in the human body. This, in turn, changes the acid/base balance or pH of the body. Since many physiological processes are dependent on a narrow range of pH, it affects how the body operates and the person feels. Altitude sickness is a well known short to medium term manifestation of this. Might mood alterations be another?

The last few paragraphs of the article mention other possible causative factors to the suicide problem in Utah. Certainly these are important when assessing the situation and at risk individuals.

The other article,, discusses the protein, beta-catenin, which seems to act as a factor in depression, anxiety, and resiliency of emotions. Once again, I think it would be short-sighted to think that some sort of beta-catenin therapy would solve the problems caused by anxiety or depression.

EEG neurofeedback is agnostic to these issues. It works by appealing to better function of brain systems by guiding the electrical activity of the brain. While it is true that a brain under extreme duress from physiological or environmental insults would have difficulties responding to neurofeedback, it has great utility for most cases of depression. Neurofeedback conveys an ability to treat something as complex as depression without having to know all the details of how that depression has come about.

It would be lovely if we could identify all the potential causes of depression and fix them. Until then we have the potentially powerful tool of EEG neurofeedback.

Deep Brain Stimulation

Scientific American has posted a guest blog on their MIND feature from psychiatrist Don Malone of the Cleveland Clinic. He has been involved with research on Deep Brain Stimulation (DBS) for a number of brain conditions including obsessive-compulsive disorder and depression. Here is his article:

My first reaction to this article was, “Why have the patients he describes received trials of medication, counseling, electro-convulsive therapy (ECT), and other treatment modalities, but not EEG neurotherapy before undergoing as drastic and invasive a procedure as DBS.” DBS involves introducing a foreign object, a wire, into the brain. It needs to be connected with the electronic stimulator. This has the potential to be a major cause of complications just as any time the integrity of the body is breached. On top of all this, it seems to work well in only about 50% of those who undergo the procedure and it is very expensive to set up and maintain.

EEG neurofeedback significantly helps around 80% of those who undergo neurotherapy for depression and OCD. It is non-invasive and usually costs considerably less than 1/10th of initial DBS. Few patients need follow up neurofeedback sessions to maintain their functional gains. Wouldn’t this be a much more productive way to spend our healthcare dollars? Those who seem to be good candidates for DBS after a fair trial of EEG neurofeedback could then be referred on for the procedure.

Secondly, I agree with the main premise of his blog. While a few people seem to grab better brain function and soar with it, others need to be coached and counseled into using their brains in ways that they have never know or realized possible. This is a learning process and like any learning process takes time, effort and persistence. Brain health needs to be supported by excellent health habits such as diet, exercise, sleep, appropriate brain challenges, good mental health support, and minimizing stress. Quick and easy fixes are rare.