Major depressive disorder affects nearly 16 million Americans a year, including me. Like many other Americans, I have been advised by a doctor to follow a routine of psychotherapy and medicine, which together are referred to as the most effective treatment for major depressive disorder.
Unfortunately, effective doesn’t also mean good, in my and many other scientists’ opinion. The lengthy side effect lists, the black box warnings – the strictest FDA warning that can be given, which in this case references the risk of suicide when taking an anti-depressant – and the need for an entire separate diagnosis of treatment-resistant depression makes me wonder if we can do better.
Not to say that medicine is not an important tool in treating depression, as many have found relief that way. Currently, around one in 10 Americans are taking SSRIs, or serotonin selective re-uptake inhibitors, the gold standard drug to treat depression and anxiety disorders. Yet pushback from the scientific community and users of these drugs over the negative effects is mounting. Just this year, a review of 131 clinical trials using SSRIs totally questioned their clinical relevance and suggested their net effect was more harmful than helpful.
With future drug development in psychiatry creeping along and being described by our brightest research minds as a daunting task, it seems appropriate to look to other tools to build a more efficacious treatment for major depressive disorder and other mental illnesses.
Interestingly enough, that better treatment may just be as simple as heating yourself up.
The results, with limited, mostly physical side effects, sound too good to be true
A collaborative effort, led by psychiatrist Clemens Janssen at University of Wisconsin–Madison, piloted the first ever double blind clinical trial to try and show that hyperthermia can relieve symptoms of major depressive disorder better than SRRIs can – and that it can do so without any of the dreadful side effects like extreme weight gain, panic attacks, suicide attempts, insomnia, or sexual dysfunction that can accompany those drugs. At most, patients experiencing mild hyperthermia treatments experience dehydration, nausea, and headaches. The results sound too good to be true.
The study enrolled men and women ages 18 to 65 who had major depressive disorder for at least four weeks prior to joining. None of the participants were receiving pharmaceutical treatments during the study, and they were also asked to take the Hamilton Depression Rating Scale, a questionnaire used to standardize and understand the severity of the individual’s depression across multiple time points in the study. In total, 16 participants underwent treatment and 14 underwent a control treatment that mimicked the effects without duplicating them.
To induce whole-body hyperthermia, the 16 participants laid down in a device that covered and isolated their bodies from the neck down. Inside the chamber, infrared lights aimed at their chest and legs heated their body to 38.5°C (101.3°F). It took 107 minutes, on average, to increase core body temperature to this target, and then the heating machinery was turned off and a 60 minute cool-down period was initiated. For the control group, all conditions were the same, except a heat fan was used to warm participants, so they thought they were receiving an active treatment. That group’s body temperatures were only increased to 99 degrees Fahrenheit, significantly lower than the hyperthermia group.