DBS was presented as an option my parents and I could look into as a treatment for my mental health issues, specifically my OCD by many psychiatrists I have seen over the years due to my lack of response to so many other treatments - but after referrals and appointments, it was finally evaluated and decided to be an option by Doctors in The Royal Melbourne Hospital in December last year (2021).

This is something which I have now undergone the surgery for at the end of August (2022)- if you see me around - this is the reason for me currently having no hair!

DBS is a procedure which involves electrodes being implanted into the brain to provide targeted stimulation of neurons to stimulate and alleviate the effects of a few different disorders - but for me, hopefully OCD primarily, depression and a tic disorder. These electrodes are stimulated by a pulse generator which is implanted below my collarbone. There are leads make their way from my brain down my neck to this generator. The signals are gradually turned up over time and controlled by an app. The strength is determined by response and by the condition being treated.

Not an image of me… but this is what things look like inside my head now.

To have this neurosurgery, I had to have a Mental Health Tribunal to ensure I understood the enormity and implications of this procedure and could consent to it happening. This is of course very important, but some of this had to do with the tricky history around brain surgeries on people with mental illness - often with procedures creating brain lesions and permanently harming people and this being done without consent. This is also a reason why I couldn’t undergo this procedure closer to home in NSW. The state legislation & mental health act doesn’t allow for this and isn’t up to date with the medical research available - even though it is done in NSW for Parkinson’s.

As much as it would be fabulous if it was, DBS is not something which works immediately - it takes a few months for the effects to be noticed. The surgery might seem like the major step and whilst it definitely is, it’s actually only the start in the whole process. But hopefully DBS will bring me some relief that meds, therapy and ECT haven’t been able to fully get me to feel and to feel much less anxious and obsessive and my depression can be managed without so much ECT, even if I can’t quite remember what this exactly feels like as its been this way for such a long time now.

So far DBS has been fine for me, although the process complicated - hopefully it will pay off in the long run. Let’s get the word out there and let’s make this available for people across Australia who can benefit from these new and emerging treatments.

To find out more about how this works - check out this - The RANZCP Clinical Memorandum on DBS in Psychiatric Practice for some more information. But here are some of the basics…

Electrodes implanted into the brain provide stimulation to targeted regions - stimulating neurons and connections. This is controlled through a stimulation device in the chest. This has the potential to reduce symptoms of the disorder being treated. However, only for those with severe, treatment refactory disorders.
DBS is adjusted until it reaches a specific level of stimulation which is likely to be effective to the individual. This process takes some time to adjust and to get to the correct level (and can continue to be adjusted, turned off & the device entirely removed - with no lesions made in the brain).
More research into this area is encouraged as this area of treatment evolves, however difficulties regarding legislation, expertise in this new and emerging area and the acceptance as a potential (rather than experimental) treatment (Mosley et.al., 2021).

Mosley PE, Velakoulis D, Farrand S, et al. Deep brain stimulation for treatment-refractory obsessive-compulsive disorder should be an accepted therapy in Australia. Australian & New Zealand Journal of Psychiatry. 2022;56(5):430-436. doi:10.1177/00048674211031482

RANZCP. (2022). Deep Brain Stimulation (DBS) in psychiatric practice. Royal Australian & New Zealand College of Psychiatrists. https://www.ranzcp.org/files/resources/college_statements/clinical_memoranda/cm-deep-brain-stimulation.aspx