DEPRESSION CONNECTIONS

A recent article in the Los Angeles Times reports that almost seven (7) percent of the U.S. adult population — about 17.6 million people — is diagnosed with depression, according to the National Institute of Mental Health. The national Centers for Disease Control and Prevention report that depression costs 200 million lost workdays each year at a cost to employers of $17 billion to $44 billion.

There are effective treatments for depression, including, researchers said recently, meditation. But neither talk therapy nor the existing medications work for everyone. And it can take up to six agonizing weeks for the most common antidepressants — Prozac, Zoloft and Lexapro — to work fully.

Additionally, estimates are that only about half of people with depression seek treatment.

New treatment plans are currently being studied, including:

Vortioxetine
The federal government recently approved vortioxetine for the treatment of adults with major depressive disorder. The commercial name of vortioxetine, a variant on serotonin reuptake inhibitors that are the mainstay of depression treatment, is Brintellix.

Research on rats, submitted by the drug developer to U.S. regulators, suggested the drug may improve some dimensions of memory. A trial in human subjects showed that those taking it had better cognitive function than those taking duloxetine, which is marketed as Cymbalta. The government declined to approve those claims until they were replicated and extended by additional research.

Ketamine
Ketamine is an anesthetic used in human and veterinary medicine, and its ability to rapidly reduce depressive symptoms in people who have responded insufficiently to antidepressants has generated great interest in the scientific and clinical communities. A study of 72 patients, presented last year at the American Psychiatric Assn. annual meeting, found that more than half reported fewer symptoms after one intravenous dose of ketamine.

Ketamine, a legal drug but not federally approved to treat depression, not only works quickly but its effects also can last three to five days or more, said Dr. Carlos Zarate, chief of the section on the neurobiology and treatment of mood disorders at the National Institute of Mental Health.

Those qualities mean it could be useful for patients in danger of committing suicide, Zarate said.
Ketamine's side effects include hallucinations, and several pharmaceutical companies are working on ketamine-like alternatives, he said, adding that he expects such drugs on the market by 2017.

Transcranial magnetic stimulation
TMS administers brief, magnetic pulses to the brain by passing high currents through an electromagnetic coil adjacent to a patient's scalp. The targeted magnetic pulses stimulate the circuits in the brain that are underactive in patients with depression with the goal of restoring normal function and mood. TMS can be administered on both an inpatient and outpatient basis.

TMS was cleared by the U.S. Food and Drug Administration to treat major depressive disorder in adults for whom medication did not work. For most patients, treatment is administered daily for four to six weeks, 40 minutes a session.

Cranial electrotherapy stimulation
CES involves small, hardly noticeable, electric current pulsed across the patient's head in a device that can be used at home. One on the market is the Fisher Wallace Stimulator, a portable, battery-powered generator cleared by the FDA for symptomatic relief of insomnia, anxiety and depression, and for treating chronic pain.

Deep brain stimulation
This surgically implanted, battery-operated neuro-stimulator, the size of a stopwatch and similar to a heart pacemaker, is used to treat a variety of neurological symptoms, especially those resulting from Parkinson's disease. 

 On LOST, we saw both Hurley and Jack use Clonazepam,  a benzodiazepine used as an anti-anxiety medication.  Benzodiazepines are tranquilizers and sleeping pills used therapeutically to produce sedation, induce sleep, relieve anxiety, muscle spasms, and to prevent seizures. Too much, used too often, can lead to memory loss. If used for extended periods, they can cause dependency and depression. The side effects of clonazepam are worsened when taken with alcohol.
 
Hurley's sanity was challenged when he was on the island.  Despite his use of humor, he struggled with stress; Sawyer called him "crazy" among other demeaning things, which he resented, and he continued to battle his eating disorder as the food drop tempted him. At one point, Hurley asked Sawyer if he had clonazepam in his stash because his old friend Dave reappeared and tormented him.

Off the island, Jack was plagued by visions of his father. Believing this to be a hallucination, he asked a doctor to write him a prescription for clonazepam and she did so, but advised that he seek psychiatric help for his problems.  Upon receiving his prescription, Jack apparently ingested his clonazepam together with alcohol, which is known to intensify the drug's effects.

There is an interesting connection between both Jack and Hurley: an anti-anxiety medication that has side effects of memory loss, depression and psychiatric issues. On the island, it had properties of electromagnetic energy which may have caused hallucinations in the castaways. Room 23 was the Dharma station which seems symbolic of cranial electrotherapy stimulation to brain washing. And throughout the series, mental manipulation was used as means of controlling character behavior.

These new methods of treating mental disorder have side effects similar to our characters trials both on and off the island: depression, anxiety, hallucinations, mood swings, memory loss and suicidal tendencies.

There is also the connection that both Jack and Hurley became the island guardian. Is it possible the reason that both Jack and Hurley were the final candidates was that they had been treated with drugs that altered their mental consciousness?

In the general theory that the LOST characters were not plane crash survivors but merely mental patients hooked up to various machines and medication routines is bolstered by the fact that there are startling connections between the one character known to have mental issues, Hurley, and the one person most fans view as the rock steady hero, Jack. But in a base line mental examination, both Hurley and Jack were quite similar in their neurosis profiles. Both had various levels of father abandonment or daddy issues. Both had a parental burden to improve their lives. Both had parental issues to go out and find a good woman, settle down and have a family. Both had disastrous off-island personal lives.

And what happens when Hurley and Jack stop taking their meds? There should have been serious consequences for both of them - - - but in the show, nothing adverse happened to them. One could assume that result was that they were both still taking their medications and the island events were not real. The medications were part of a treatment process and the island dream state was a side effect.

The idea that the main characters were hooked up to machines to treat their mental disorders, but somehow cross-circuited into a new collective mental realm to live out those feelings and issues is quite appealing to those who think the character-driven story promise failed to live up to expectations.