Virtual Reality, Zoom Therapy And LSD: New Ways Of Treating Mental Health Issues
Illustration by Ms Stefania Infante
The public awareness of mental health issues has come on leaps and bounds over the past decade. The inevitable mental health fallout from the ongoing pandemic will undoubtedly accelerate this further. There are, however, still areas where the general understanding of mental health is still catching up. Specifically, the current options available for treatment.
You ask most people how mental health issues are treated, they’ll likely offer some variation of pills and medication, usually antidepressants, or therapy, as in talking to a counsellor or therapist. However, this is a narrow and limited view of how mental health problems are dealt with today, and it overlooks just how many advances have been made in the field of mental health treatments in recent years – and how many more are in the pipeline. Here are some of the more intriguing examples.
Most antidepressants typically prescribed for mental health treatment today work in similar ways, usually by increasing the presence of neurotransmitters (such as serotonin, dopamine and noradrenaline), the chemicals that fire information through the brain. By stimulating this network, what we call the monoamine system, regions of the brain that have become sluggish can be jolted back into action.
The influence of the monoamine system, however, is subtle, making this a slow and gradual process, like gently blowing on the guttering flames of a campfire to coax it back to life. It means that, despite antidepressants taking hold at a chemical level as soon as they enter the body, it can take up to three weeks before they kick in. This lag time can, reasonably enough, lead some to conclude that the drugs don’t work.
The answer? Find the drugs that do work, or, at least, have a more immediate effect. Some of the remedies currently gaining traction in the field might raise a few eyebrows: LSD, magic mushrooms and ketamine.
More commonly associated with their use as narcotics, these psychotropic drugs stimulate the depressed brain regions far more directly than most current antidepressants. They do so by targeting the glutamate system of the brain, which is responsible for around 90 per cent of neurological activity. In short, they don’t gently blow on the campfire, they crank up the flamethrower and give it a direct blast.
Obviously, such drugs should be handled with extreme caution and used only in controlled environments, where legally permitted. You can’t powerfully stimulate the brain without side-effects, hence why these substances are considered dangerous. But if refined and focused, the potential therapeutic benefits are considerable. Indeed, the first antidepressant based on ketamine, administered via a nasal spray, was approved for initial use in the US just over a year ago. Results suggest it has beneficial effects within one day of initial dose, sometimes even within a few hours.
Feedback, avatars and virtual reality
Most mental health problems don’t have any tangible “presence” in the real world; they’re highly subjective. This can lead to stigma and doubt from others, but also means it’s harder for individuals to face up to and tackle the problems they’re experiencing. How are you meant to deal with something you can’t see or hear, and don’t know where it ends or begins?
Just as with the development of drugs and psychiatric medications, the non-pharmacological side of mental healthcare is also becoming increasingly high-tech. One example is the use of feedback (or neurofeedback) therapy. Take someone who experiences anxiety attacks – with feedback therapy, they’re attached to a monitor displaying their heart rate or blood pressure. (If it’s neurofeedback, it’s specific brain activity that’s shown.) So, if they have an anxiety spike, rather than being told to “calm down” – a vague instruction at the best of times, let alone in the midst of a panic attack – they’re told to try and reduce the activity on the monitor, to bring their blood pressure or heart rate down. This is often easier to do as it grounds the process in something tangible and gives your thinking brain something to work on and learn from.
More sophisticated versions of this approach are emerging all the time. Avatar therapy is a modern intervention where the hallucinations and other symptoms experienced in disorders such as schizophrenia are “represented” by a software avatar. This allows the patient to think, “It’s not ‘me’ saying all this scary stuff, it’s this guy on the screen”. Similar approaches using virtual reality are being explored for treating PTSD, phobias and beyond.
People often dismiss mental health problems as being “all in your head”, which often only makes them harder to deal with. Modern technology has made it possible to bring such issues out into the real world, where they can be far easier to confront.
Mental health problems, even moderate ones, can be highly debilitating – which in turn can make them harder to treat. Travelling to meet a counsellor in another part of town, or even just going out to pick up a prescription for medication, can feel like an ordeal when you’re wracked with paranoia, intensely afraid of the outside world or lacking the necessary motivation to even get dressed.
This is where technology is proving useful once more. The pandemic has highlighted the everyday uses of Zoom as a tool for communicating over distance. Its wider adoption for office workers makes remote therapy sessions all the more practical, familiar and viable.
Not having to drag patients from the perceived safety of their home could potentially make all the difference in getting people to successfully engage with therapy, especially in the early stages. And with less logistical hassle for not just patients but also therapists, the latter has more time to deal with other patients and get more done overall.
There are even efforts to create therapeutic software. Mindfulness apps such as Headspace are increasingly popular, but they are not intended for clinically unwell patients. The next step is to build a programme that can actually do the work of a trained medical professional.
People regularly highlight concerns about how modern technology is harming our mental wellbeing, but they seldom stop to consider that the opposite may actually be true.
MR PORTER does not endorse the treatments mentioned in this article. Always seek advice from a medical professional.