Exactly five years ago today, I was implanted with the VNS Therapy System (the vagus nerve stimulator) in the double-blind, placebo-controlled investigational trial of vagus nerve stimulation for the treatment of chronic depression. I had never even heard of the vagus nerve, but I had absolutely nothing to lose and everything to gain. There are no words which can adequately describe my gratitude for how this therapy changed my life. Fortunately, this medical breakthrough treatment has been FDA approved and patients are benefiting from this remarkable therapy. Centers for Disease Control and Prevention The April 2006 Issue of the Centers for Disease Control and Prevention publication Preventing Chronic Diseases published some very interesting information about the importance of integrating care for medical and mental illness. Here is a summary of the conclusions of the study: Two review articles present overwhelming evidence that mental disorders and medical illnesses are strongly linked. Medical illnesses such as cardiovascular disease, diabetes, asthma, and cancer are associated with mental illnesses, and the more serious the medical condition; the more likely it is that the patient will experience a mental illness. Individuals with depressive disorders are about twice as likely to develop coronary artery disease, twice as likely to have a stroke, more than four times as likely to have a myocardial infarction (MI), and four times as likely to die within 6 months of an MI as people without depressive disorders. Depression is a common poststroke condition, and effective treatment of depression can improve cognitive functioning and survival. People with diabetes are two times as likely to have depression as the general population, and the presence of depression as a comorbidity to diabetes is associated with poor adherence to medication regimens, greater complications of diabetes, increased numbers of emergency room visits, and poorer physical and mental functioning. Health care expenditures are more than four times greater for people with diabetes who have depression than for people with diabetes who do not have depression. Symptoms of depression and anxiety are common (up to 50%) in people with asthma. The presence of depressive symptoms increases as the frequency of attacks increases. Individuals with cancer commonly have mental disorders, especially depression; effective treatment of depression is associated with decreases in pain and symptoms as well as improved immune functioning. Interestingly, improved hemoglobin levels in people with cancer have been reported to improve depressive symptoms, reminding us again about the link between medical and mental disorders. The link between medical and mental illnesses thus extends to treatments, not just the diseases. Chronic pain, Alzheimers disease and Parkinsons disease, epilepsy, and obesity are other conditions in which mental and medical disorders routinely coexist and in which the presence of a mental disorder impairs functioning and effective disease management. Finally, people with mental disorders also have impairments in everyday functioning and have greater difficulty following medical regimens, leading to poorer response. Moreover, people with mental disorders are more likely to smoke and abuse alcohol and drugs, leading to greater risk for medical illness and poor adherence to medical treatments. The World Health Organization has defined health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Physical and mental diseases are inextricably bound, and improving one improves the other. Improved mental and physical health will improve quality of life and social well-being. The evidence tells us what we already know; the work ahead is to turn evidence into everyday practice. The only FDA approved long-term treatment option for chronic depression is now available and being introduced to the psychiatric community: vagus nerve stimulation. You can learn more about this remarkable treatment at http://www.VagusNerveStimulation.com A prescription from an M.D. is required for this ninety minute out-patient procedure. |
