What we have learned about electroconvulsive therapy and its relevance for the practising psychiatrist.
- Pascal Sienaert
- Canadian journal of psychiatry. Revue canadienne…
Depression is one of the most prevalent mental disorders in the general population. The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) defines Major Depressive Disorder (MDD) as one or more Major Depressive Episode(s). A Major Depressive Episode must include a period of at least 2 weeks during which there is either a loss of interest or pleasure in nearly all activities or a depressed mood. MDD affects anywhere from 10-25% of women and 5-12% of men within a community sample. For lifetime MDD, the total prevalence is approximately 16.2%, Abstract Objective: To discuss the effects of chiropractic care utilizing a functional neurological approach for a patient with an eleven year history of Major Depressive Disorder (MDD). Clinical Features: A 28-year-old male presented with an eleven-year history of depressive symptoms including: loss of interest in pleasure in almost all activities, a lack of reactivity to usually pleasurable stimuli, and significant weight loss. The patient was diagnosed with MDD at the age of twenty and subsequently treated medically through the use of multiple anti-psychotic medications and multiple rounds of Electroconvulsive Therapy. Intervention and Outcomes: The patient was treated over a period of one year and three months at a rate of 2-3 visits per week utilizing a combination of chiropractic techniques including Activator instrument as well as high velocity, low amplitude (HVLA) spinal adjustments, most consistent with Diversified Technique. Adjustments were constantly varied in relation to patient positioning (prone, supine, seated, and standing) to promote a variety of cortical stimulations. The patient was also adjusted utilizing hemisphere specific intervention designed to improve hemispheric coordination and sensory integration. Additional optokinetic home exercises were given as an adjunct to care. The patient reported a complete resolution of all depressive symptoms, termination of all related medications, and cessation of smoking while under chiropractic care. Conclusions: We presented a case of a patient with MDD utilizing hemisphericity based chiropractic and rehabilitation which resulted in marked resolution of the patient’s depressive symptoms over the course of one year and three months.