10 thoughts on “Treating Depression with tDCS

  1. Ah John, see that both messages are here – have been to reddit site but am a bit daunted by all the techno-jargon – Jessica

  2. Oh John – thank you so much! Sorry I haven’t been back here to see if there were any more messages.- so happy to see yours! I have purchased a machine!!! Dr Fugedy recommended 3 machines and I chose the one he seemed to favour – my friend had to get her South African psychiatrist to write a referral to the company – they do not sell to individuals without a doctor’s referral – but machine should be here hopefully sometime next week – I am trying not to get too excited as with my luck in this area my brain will resist even this – but no point without at least a molecule of hope. I will now spend time on the websites you have recommended – I am SO grateful to you for your help – may I be bold and ask to know a little something about you and your interest in this treatment? Do you want to send me your twitter name? (I am lazy and so far follow no one (don’t have smartphone so following hard work!)…..you could be my first) –

  3. Hello again – just realised that “John” is not Dr Brent Williams! – sorry John! wasn’t paying attention – assumed Brent was writing back – anyway, I thank YOU, therefore, for your thoughts on this issue – I listen to everyone – and am grateful for all philosophical, technical, medical, ethical and any other considered opinions and suggestions – thanks again and please feel free to continue!
    Jessica

    • Jessica I have some UK followers in Twitter. I’ve asked for help finding a depression study or practitioner. No luck so far but I’ll keep trying. Again, I’d encourage you to try http://www.reddit.com/r/tDCS/. I know I’ve seen some UK people on there who bought a device mail-order and were reporting their findings. You might find someone local to you who could help out.

      • Hello John! I wrote you a substantial message yesterday but it seems to have disappeared – don’t want to repeat myself in case it got to you somehow but isn’t appearing on here – but will at least repeat the fact that I have ordered a machine! One recommended by Dr Fugedy. It should be arriving next week. Now will spend much time going to websites recommended by you. Must find some training in UK!
        Also was curious about you and your interest in depression, tDCS, etc – how do I follow you on Twitter?! Hope THIS message gets through and will look forward to reply. Thanks again for all your help. It is truly appreciated – and so immensely kind of you……

  4. Hi John,
    I cross-referenced tDCS, depression and Great Britain; and Jessica’s message and your reply came up. As a proponent of the domiciliary (at-home) use of tDCS, I look forward to it becoming more available, but I have grave reservations with unsupervised self-administration. For instance, there are recent reports of manic and hypo-manic episodes in depressed patients treated with tDCS. The incidence of suicide is significantly increased in depression. What happens if there’s an untoward event? Where’s the safety net for the self-administrator? What is the blogger’s responsibility and liability? In the extreme event of suicide, is the occurrence in spite of tDCS or the result of tDCS? Who wants to be the first to have to answer this question?

    As a physician, I evaluate and train each patient for tDCS. I personally confirm that tDCS is appropriate and the person is competent to do the procedure. More important is the availability of at-home supervision via Skype, e-mail and telephone, what to do if there is a problem. The safety of tDCS thus far results from administration by trained and competent providers. Well-meaning and well-read amateurs may achieve benefits of tDCS, but what if something goes wrong? Self-stimulation is potentially as dangerous as self-medication. Treating patients with tDCS for 6 years in the clinic and at-home for 2 years, I am impressed with its efficacy and safety. My underlying concern to every aspect of tDCS for every patient is what can go wrong, how I can identify it, how can I prevent it and how can I treat it if it occurs.

    The danger is not appreciating what you don’t know.

    James Fugedy, MD

    • I’m with you Jim. What we want is for tDCS/depression treatment to be widespread and covered by insurance. And it seems to me Soterix with their multi-site clinical trials for depression (and of course, Colleen Woo at Black Dog Institute) are doing their utmost to pave the way towards that day. But what do we tell someone like Jessica who might not be able to afford to consult but who is desperate to try something people say is working? Considering the risks of pharmaceutical-based treatment most doctors are so eager to prescribe, I have to wonder if the remote possibility of an adverse tDCS (“One participant with bipolar disorder became hypomanic after active tDCS.”) reaction isn’t worth the risk, assuming someone has taken the time to fully acquaint themselves with all the available information.

      • Please forgive any repetitions, bad grammar, etc, am writing this with only half a brain….

        Hello Doctors! I can’t tell you HOW PLEASED I was to see your replies to my concerns and desperation! I agree with everything you have both said – and you can, I am sure, imagine how frustrating (to say the least) it is to see how MUCH information there is available “out there” on this treatment and all the research there has been and continues to be done using tDCS (for so many conditions!) – and I would absolutely share your concerns about its unsupported use and lack of training and follow-up. As I said in my letter to Dr Fugedy (to whom I now owe a reply) I am intelligent, well-educated and certainly motivated. Yesterday I could not have even written this message, my depression has taken on a new mutation of random dips into the abyss followed by rising slowly back up to numb dreariness followed by the usual dysthymic default position – as I mentioned to Dr Fugedy, I have suffered for decades from this illness and know it very well – it has blighted my life and when I read about the tDCS on PsychCentral I was so heartened – as it is available NOW – and also having tried EVERY chemical option (tri-cyclics, SSRIs, SNRIs, MAOIs, NARI, etc! with only 2 brief successes which were, sadly, short-lived – + much therapy of all kinds, some helpful – but therapy at least in my case – has failed to fix what I see as a “broken” brain – a physiologicalneurological problem) you can understand my enthusiasm – (though hope is not convinced – at least it is lurking) — and also – really – it is for me SO SHOCKING – to discover the ignorance (and apparent lack of curiosity or interest) amongst the psychiatric community here in the UK – really shocking considering how much genuine and positive research is being done (yes, even here, it’s true! and written up in EVERY neuro/psych journal! – to go to a consultant psychiatrist who just looked blankly at me when I mentioned tDCS – and who didn’t even offer to investigate it for me!) well I remain undaunted as I simply cannot contemplate continuing in this life of mine as it is now – which due to this illness has lately telescoped down to zero – as I also said to Dr Fugedy, I have nothing to lose. My main problem, most of which is the result of my depression-blighted life – having much much education (3 1/3 degrees (summa cum laude for 3 of them – I mention this not to brag but partly out of shame that I have managed against the oddes to complete this education but due to intermittent illness and lack of confidence have never been able to establish a career – so am now living on a tiny state pension of £140 a week + small savings – which is why I was hoping to purchase a machine and then find some training that I could afford – hopefully online somewhere – youtube???) – I understand and share Dr Fugedy’s concerns and would feel much more reassured to have expert training, back-up and ongoing support, but at the moment cannot afford it – (if only I’d known this treatment was available when I was working! I’d have put some money aside specifically for the purpose!) – in any event, I am grateful to you both, Dr Williams (btw I read your incredible wife’s inspirational blog – oh to have such an optimistic, open and happy brain!) and to you Dr Fugedy for at least taking my situation seriously and for not ignoring my concerns – my friends who have been lucky with their mental health professionals agree that the most important thing in the journey to remission (if not recovery) one needs is to feel that someone (mh professional) is on one’s side and is listening and taking one’s illness and potential treatments for recovery/improvement seriously. Thank you both for your contributions. I will access the links, Dr Williams and welcome any further advice/information you can offer. Again, thank you both SO MUCH for your replies and help.

        Kind regards
        Jessica (American/British – interpond citizen!)

        ps – my main concerns – not understanding anything! about electrical objects/processes – is correct placement of the electrodes – the correct size of the electrodes – have read that this can make a difference – and basically how one knows what power to use 1 or 2 – how to turn on the machine! 😉

  5. Hello Dr Williams

    I don’t know if you will get this message but I couldn’t find another way to contact you. I am interested (desperately) in trying tDCS for my treatment-resistant depression. I have already contacted Dr Furedy in Atlanta regarding this. However, I live in the UK. tDCS is not available in the UK and there is nowhere in the UK to purchase a machine. I have no frame of reference or baseline regarding price and training for its use in treating depression – Dr Fugedy charges $2400 for machine and one day training (via skype)- can you please tell me if this is reasonable? I keep reading that the machine is simple and inexpensive to purchase, and that the training not difficult to understand, so $2400 seems alot of money for this – although I am so desperate after a lifetime of suffering – I am willing to pay this (even though I am on an exceptionally low income) – therefore I would be so grateful if you could at least tell me if you think Dr Fugedy’s charge for this is comparable to others who might reliably offer the same thing or if you know of any other reliable doctor who could also offer me training if I could get a machine myself.
    Also, I would be so grateful if you could let me know of a reliable machine I could purchase on my own, order from the US or Europe? as I also have the possibility of being trained by a friend’s psychiatrist practicing in South Africa. The UK is so far behind in this field, it is so dispiriting and frustrating. I am so truly grateful for your website as I am a person who likes to have as much information as possible about my illness and potential treatments but of course, the internet is full of unreliable information which makes it especially encouraging to find a site like yours.
    Thank you very much for any information you can give me. And good luck with your life-changing experience – I am hoping for one of those myself, if only I can fix my broken brain!

    Kind regards
    Jessica Blueberry
    Harpenden Herts UK

    • Hi Jessica,
      You can find Dr, Williams here: http://speakwisdom.wordpress.com/. He has replied to a few of my comments on his blog. I found ongoing clinical trials for depression in France, Germany and Switzerland, but none in the UK. Which surprises me because so much is being investigated at Oxford. That said, IMO no, you don’t need to spend that kind of money to get started. As I understand it, Dr. Fugedy would be spending an entire day or more with you on Skype to ensure you fully understand the process, but there are enough resources right here on this website for you to put together your own protocol. What I would do in your situation is post your question to the Reddit tDCS group here: http://www.reddit.com/r/tDCS/ I know I have seen posts from UK users. I would also suggest you commit to spending an hour or two a day reading the literature around tDCS and depression. You could start with these two videos Dave Siever and Electrode Positioning and Montage in Transcranial Direct Current Stimulation. It would be great to hear back from you in this comment thread. Keep us posted.
      John

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