Author: Alan Manevitz

CBS News – Dr. Max Gomez: Helping Depressed Patients Get Some Sleep Development Could Make A Huge Difference For Many Depression Sufferers

A new study funded by the National Institute of Mental Health found that treating insomnia in people with depression could double their chances for full recovery.

Insomnia is an extremely common problem associated with depressions affecting more than half of the 18 million depressed patients in the country. CBS 2’s Dr. Max Gomez reports on the findings of the study which could make a significant difference for people fighting depression. The development was also reported by the New York Times.

I have been suffering from depression for quite some time and it’s almost impossible to sleep,” Michelle said. Michelle said that she would go for days or weeks without sleeping if she didn’t take her sleep medication and it made her depression worse. “It can make you not focused and irritable. It can make you feel not part of the community of the world. It can make you feel like an alien,” she said.

It is unclear whether insomnia is a symptom or a cause of depression but a number of studies are looking at whether treating insomnia with special talk therapy can make a difference in depression.
Continue reading “Treating Insomnia With Special Talk Therapy Can Make a Difference in Depression”

TUESDAY, Nov. 12 (HealthDay News) – By Steven Reinberg, HealthDay Reporter – When willpower doesn't work, smokers who want to quit may have a new tool someday: magnetic brain stimulation.

A study of 115 smokers found that 13 sessions of the treatment over three weeks helped some heavy smokers quit for as long as six months.

This noninvasive technique, called repeated high-frequency transcranial magnetic stimulation, sends electric impulses to the brain. It is sometimes used to treat depression.

"Using noninvasive stimulation can reduce nicotine craving and smoking," said lead researcher Abraham Zangen, an associate professor at Ben-Gurion University of the Negev in Beer-Sheva.

"If you stimulate regions in the brain that are associated with craving for drugs, you can change the circuitry in the brain that mediates this dependence and eventually reduce smoking," he said. "And many of those treated stop smoking."

The study participants smoked at least a pack a day and had failed at least two previous attempts to quit, said Zangen, who has a financial interest in the equipment used in the study.

The researchers divided the participants into three groups. One group received high-frequency brain stimulation, another low-frequency stimulation, and the third received a phony treatment. The groups were further divided into those who saw a visual cue — a picture of a lit cigarette — just before stimulation and those who didn't.

The idea of the cue is to make sure attention is directed at smoking and not some other craving, Zangen said.

After 13 treatments, those who received the highest level of stimulation plus the visual cue had the best results — 44 percent of them had quit. After six months, one-third of this group were still not smoking compared to 28 percent of those who weren't shown the visual cue before treatment.

The results of the study were scheduled for presentation Tuesday at the annual meeting of the Society for Neuroscience in San Diego.

Although magnetic brain stimulation is approved by the U.S. Food and Drug Administration for treating depression, it is not yet approved for helping people quit smoking, Zangen said.

Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City, said, "It's a very effective treatment for depression and anxiety."

Manevitz thinks using it to help people stop smoking makes sense. Other studies, he noted, have found that stimulating an area of the brain called the insula can reduce the desire to smoke.

"Adding brain stimulation to other smoking cessation methods like nicotine substitution might make it even more effective," he said.

When used for depression, magnetic brain stimulation costs from $300 to $350 a session, and the treatment may not be covered by insurance, Manevitz said.

For the treatments, participants wear a helmet fitted with coils that deliver magnetic stimulation to the areas of the brain — the prefrontal cortex and the insula — associated with nicotine addiction.

Dan Jacobsen, from the Center for Tobacco Control at North Shore-LIJ Health System in Great Neck, N.Y., thinks the idea is interesting but he doesn't see this becoming a viable treatment option anytime soon.

"This treatment is not a simple procedure," he noted. And the six-month results weren't as good as the success rates for other treatments, including medication and nicotine replacement, combined with behavioral components, he said.

Side effects from the treatment were mild and included headaches or muscle twitching. These symptoms went away with continued treatment, Zangen said. One potentially serious but rare side effect is that brain stimulation can induce a seizure, especially in those prone to epilepsy, he noted.

Data and conclusions presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.

WebMD: Insurance coverage for mental health problems is changing – for the better.

In the past, your insurance might have paid 80% of the cost of seeing your primary care doctor but only 50% of the cost for seeing a psychologist, for example.

But a new law that began taking effect in 2010 changed the rules. Under the new law, if a private insurance plan provides coverage for mental health and substance use services, the plan's coverage must be equal to physical health services.

For example, benefits must have equal treatment limits, such as:

• Number of days you can stay in the hospital
• How often you get treatment

Also, limits on the amount you pay on your own need to be similar for both physical and mental health services, such as:

• Lifetime and annual dollar limits (the total amount an insurance company will pay)
• Out-of-pocket maximums (the total amount you have to pay)
• Co-payments (a fixed amount you pay for a health care service)
• Co-insurance (your share of payment for a health care service)
• Deductibles (the amount you have to spend before your insurance company starts to pay)

If your health insurance covers some or all of the cost of going out of network for a physical health problem, it has to do the same for a mental health problem.

There are some exceptions. For instance, the law doesn't apply to companies with 50 or fewer workers. So insurance plans available to those employees are not required to provide equal services for mental and physical health problems.

Changes on the Way

More changes are coming in 2014.

Right now, health insurance plans that provide mental health services must provide equal physical health services. But there is no requirement, presently, that health insurance companies include coverage for mental health conditions.

Starting in 2014, though, mental health and substance abuse must be covered by certain plans, including all the ones offered through the new insurance exchanges. Exchanges, also called marketplaces, are places where people who don't get insurance through their job — or don't have insurance for any other reason — can buy a plan.

Also starting in 2014, mental health or substance abuse can no longer be considered a "preexisting" condition. That means insurance companies can't deny you coverage because you had a mental health condition before you enrolled in a health plan.

WebMD Medical Reference

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SOURCES:

Kaiser Health News: "After Newtown Shootings, Questions About Mental Health Insurance Coverage."

Kaiser Family Foundation: "Mental Health Financing in the United States: A Primer."

American Psychological Association: "Mental health insurance under the federal parity law" and "How Does the New Mental Health Parity Law Affect My Insurance Coverage?"

HealthCare.gov:

Reviewed by Charlene Frizzera on April 19, 2013