Think About Beer and Italy
Loaded into a smartphone, MoodKit prompts users to link their moods, activities, and thoughts. For example, it might indicate that a user’s low point coincides with thinking his friends don’t care about him, or with eating at a fast-food restaurant. It might then help the user think about making weekend plans or eating in a park, activities associated with high points in his mood. Such guidance has long been available in books, but the phone’s interactivity, ubiquity, and privacy offer big advantages. “People don’t want to pull out Overcoming Your Personality Disorder when they’re in Starbucks,” Erhardt says—a mistake that I, for one, will never make again.
Studies of MoodKit’s effectiveness aren’t in yet. But for what it’s worth, the app is being used by thousands of people. I tried it and was immediately able to identify several problem areas in my thinking and behavior. I don’t care to share the specifics of what MoodKit uncovered in me. If I were an inner-thought-sharing sort of person, I would have solved my problems a long time ago.
But speaking hypothetically, if MoodKit were to note that a user could lift his spirits by thinking less about unmeetable deadlines and unpayable bills from his youngest kid’s college, and more about beer, expensive cameras, and his upcoming trip to Italy, the app would be doing its job quite well. In fact, the app did such a good job of highlighting those entirely-unrelated-to-me examples that I started wondering if my wife might be right about my being depressed. Fortunately MoodKit was there to remind me that thinking my wife was right was associated with low points in my mood, prompting me to think cheering thoughts that she was wrong.
As effective as cognitive behavioral therapy can be, though, being told to fix your mood problems by working on your thinking and behavior is a little like being told by the doctor to fix your cold by resting up and drinking plenty of liquids. It’s good advice, but it leaves you wishing you could just get a prescription for something that directly blasts away at the root of the problem.
“People don’t want to pull out Overcoming Your Personality Disorder when they’re in Starbucks.”
Tarique Perera is taking more of that direct-fix approach. A Harvard-trained psychiatrist and formerly a professor at Columbia University, Perera is a leading practitioner of a brain-altering process known as transcranial magnetic stimulation, or TMS. Electromagnetic coils are positioned near a patient’s skull to deliver brief pulses of magnetic fields; these induce electric currents inside the head, which cause neurons to fire in brain regions associated with mood.
Introduced in 1985, TMS was approved by the U.S. Food and Drug Administration four years ago for the treatment of depression. Using electricity to affect the brain makes tms sound similar to electroconvulsive therapy, alias electroshock therapy. But whereas the latter blankets large swaths of the brain with a whiteout storm of electrical activity—leading to temporary, and occasionally permanent, memory impairment—TMS is more of a focused tickle of the circuitry. Although the exact process by which magnetic stimulation relieves depression remains an open question, TMS practitioners have reported that about 60 percent of patients see a remission of their symptoms. Perera, who has recently established his own TMS clinic, describes this approach as “the future of neuropsychiatry.”
Terrified (like most technophiles) at the thought of being left behind in an earlier century, I tried to get someone in my area to magnetically scour away my nonexistent depression. But they all refused, citing various vague ethical concerns over physically altering the brain of someone who doesn’t have a diagnosis. (If you’re a do-it-yourselfer like me, let me save you the trouble of briskly waving magnets around the left side of your forehead or duct-taping a half dozen ringing smartphones to your skull. Neither has much effect as far as I can tell, although the latter technique temporarily causes nosebleeds and some loss of vision if the tape is too tight.)