Tuesday, September 27, 2011

Structural damage

If you get into a car accident, external damage can be seen. Crumpled bumpers, broken glass, mangled metal is a visual image that you just can't get out of your head. You can get stressed out due to the high cost of repairing the vehicle. Vehicles can be repaired, to *next to new*. Yet, if you dig into the car's history, you will know that the car was in an accident.

Now, let's equate that to the human brain. Sometimes during birth, "accidents happen"; and I'm not talking about forgetting to wear a condom and finding out 9 months later, you have a new bundle of joy. No, what I am referring to are congenital issues that cause damage prior to, or at birth.Cerebral palsy and hydrocephalus are just two examples of the many health issues that are structural in nature.

There has been new reports that may have narrowed down the how congenital hydrocephalus occurs. Apparently, a "fat cell" may be the culprit. To read more about this interesting topic, feel free to click: http://news.sciencemag.org/sciencenow/2011/09/homing-in-on-hydrocephalus.html

The one problem with "structural" damage within the brain, you can't really go to the local body shop and have them "bang out the dents". Currently, the only way to "deal with" hydrocephalus is to have an internal "shunt" or tube going from one of the ventricles in the brain and drain it off into either the heart or abdomen.


One of the side effects of having "structural damage" in the brain is that the brain does not "act normal". Information is not processed properly. Think of the brain as one humongous roadway. Freeways with on ramps and off ramps that can be "under construction", due to knew information, or damage to an area. Getting new roads, well, that's always a good thing. Yet, learning how to "get around" during the "under construction" phase, can prove frustrating. Under normal circumstances, you know how to get from point A to point B. Enter the damaged brain and re-routes may frustrate, agitate and overwhelm the that very brain. This is where depression comes into play.

Depression is not a fun thing to deal with. Yet, there are different types of depression. For instance, you have Manic Depression (sometimes referred to as Bi-polar depression), SAD or Seasonal Affective Disorder; which has a component of depression in the affliction. You might have heard about MDD or Major Depressive Disorder. Chronic Depression (also called "dysthymia"), Psychotic Depression and rounding out the "fun times" is Postpartum depression.

A great many doctors want to have the patient take pills to deal with the "symptoms" of the depression. The problem is a "chemical imbalance" is one thing. A depression caused by structural damage can not be fixed by a pill.

Doctors mean well, but sometimes they don't know what else to do to treat the patient and their last resort are pills. It is not only frustrating for the doctor but the patient goes through all sorts of emotions trying out different drugs. A few things about drugs that has to be discussed: Side effects and contraindications.

Side effects and contraindications need to be talked about by the physician and patient, so that the patient is well aware of what could happen when taking the pills.

Ahhhh, but what about those individuals that can not take medication for depression. Well, for those who can not take medication there are a few options: 1) Psychotherapy, 2) Art therapy, 3) Writing therapy, ECT or Electro-convulsive Therapy, also known as "Electric shock therapy" and 5) "Self-help".

All the above types of treatment have their merits, yet, they also have their downfalls. The patient and the treating physician should look at *all* options. Discuss the benefits and the possible problems with each type of treatment. Don't rush into any kind of treatment.

In future blogs, we can discuss the various types of depression as well as go into further detail regarding drug interactions and contraindications.