Living with chronic depression

    Chronic, severe depression. Medications. Suicide Attempts. Therapy. Hospitalization. Tara Aliotta, 50, of New Jersey has battled depression since she was 11 years old, and the illness has wreaked havoc on her life.

    She has tried many different approaches to overcoming depression, but so far, nothing has made a difference in her life. Now she is attempting what she calls her “last chance” at getting better.

    In May, Tara underwent surgery for “DBS” – Deep Brain Stimulation. DBS is a surgical treatment involving the implantation of electrodes into the brain, which send electrical impulses to specific parts of the brain. This is part of a study by the University of Pennsylvania. On this site, you can follow Tara’s journey and see if this dramatic step will pay off for her.

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    June 2010 Tara’s situation continues to be difficult. She is still living with her parents, and her father has not recovered well from his surgery. He is typically the caregiver and pillar of strength in Tara’s family, and his current frail health has put a lot of stress on everybody. Tara is not seeing any improvement from the DBS so far, but together with Dr. O’Reardon, she continues to look for new options.

    Hear the conversation with Tara and Dr. O’Reardon: [audio:100616ed.mp3]

    March 2010This time, I met Tara during her session with psychiatrist Dr. Mahendra Bhati. He is the “unblinded programmer” for the study, which means he meets with patients and programs the types of stimulation that’s delivered through the deep brain electrodes. He asks them questions about how they feel, and changes the settings on their electrodes accordingly. Here, Dr. Bhati talks about the study and his work: [audio:100316msDrBhatiStudy.mp3] Here, Tara talks about how she is doing. Her father has had surgery, and life has been difficult: [audio:100316msTaraMarch2010.mp3]

    Tara during her session with psychiatrist Dr. Mahendra Bhati.February 2010 Tara is now several months into the active phase of the Deep Brain Stimulation trial at the University of Pennsylvania. During the first (blind) phase of the study, neither Tara nor her doctors knew whether the electrodes in her brain were turned on. She did not experience any benefit during that portion of that study. Now the electrodes are definitely turned on, but Tara is still not experiencing improvements. Her doctors are working on optimizing the settings, and also changing her medications. Listen to the interview with Tara and Dr. O’Reardon [audio:100203mstarajan.mp3]

    December 15, 2009 Tara Aliotta is now in a new active phase of the DBS trial. Until October, she was in the blinded phase of the research study. During this part of the research study, some participants’ devices are turned on, others’ are not. Participants are seen by their doctors consistently, to monitor improvements, which allows researchers to track if the DBS can be credited with improvements if there are any. Neither Tara nor her psychiatrist, Dr. O’Reardon knew whether the electrodes in her brain were turned on or off. She experienced no improvement during this three-month phase of the trial, and said it was a very difficult time for her and her family. She stayed on her usual regiment of anti-depressants. She got through this time in hopes that as soon as she entered the new phase of the study, things would change for the better. Now Tara is in the active phase of the trial, the devices have been turned on for sure, and doctors are trying to optimize the settings on the electrodes for maximum benefits. So far, Tara has experienced no benefits, and is very demoralized at this point. She has had to stop working, and has moved back in with her parents. Dr. O’Reardon is hoping that it’s a matter of finding the perfect setting for Tara, and giving the device some time to start working for her. Tara is trying to make it through this very difficult time. I will meet up with Tara and Dr. O’Reardon in early January.

    June 22, 2009 Tara has entered the next phase of the study she is participating in. After recovering from brain surgery, she is now in the blinded portion of the study. This means neither Tara nor her doctor, psychiatrist John O’Reardon, know whether the device that was implanted into Tara’s brain is turned on or not. Half of the people who are participating in the study will have their devices turned on, the other half will not. I met up with Tara at Dr. O’Reardon’s office last week, right before this phase of the study was going to begin. The blinded phase will last 16 weeks, and after that, every patient’s device will be turned on so that they can experience the potential benefits of the procedure. After talking to the principle investigator in the study, Dr. O’Reardon, we decided to not post any interviews during this blinded phase, because our discussions could compromise the study. I will be in touch with Tara throughout this period, and we will resume our reporting on her story in October. This is the last interview with Tara until the blinded phase has ended. Listen:

    Tara during her session with psychiatrist Dr. Mahendra Bhati. [audio:090619mstara.mp3]

    May 14th, 2009 Ten days after her six-hour brain surgery, Tara continues to recover at her parents’ home, and will be off from work until July. At the earliest, the device that was implanted into her brain will be turned on in early June. She says while it is not in her nature to be optimistic, she is hopeful that the surgery will pay off. Maiken Scott spoke with her on the phone. Listen: [audio:090514_10days.mp3]

    May 6th, 2009 Tara Aliotta spent the first day after her operation in intensive care, and will spend one more day in the hospital. Since she is participating in a research study she won’t know if she will be in the control group, or in the group of people whose brain stimulation devices will be turned on. If her device will be turned on, it won’t happen until the beginning of June so that she can fully recover from surgery. Maiken Scott visited her today:

    Scott: Tara is recovering from surgery and seemed in good spirits. I had brought my camera but didn’t feel comfortable asking her if I could take a picture. She looked fine, but her eyes were swollen, and there were two bloody marks on her forehead, as well as two stapled scars on her head. All of this will disappear, but the question is whether her depression will fade along with the scars from the surgery. She seemed happy to see me, and remembered several parts of her surgery. Everybody participating in the study will get their brain stimulation devices turned on eventually, but for the first few months of the study, they won’t know if their device is on or off. Tara said she is looking forward to going home, and is hopeful that all of this was worth it. Interview with Tara post-op–Listen: [audio:090506msPostOp.mp3]

    May 5th, 2009: Dr. Gordon Baltuch called yesterday afternoon to say that Tara Aliotta’s surgery went well. Tara will be in the intensive care unit for the next two days. Dr. O'Reardon speaks to Tara Aliotta prior to surgery[/caption]May 4th, 2009: Dr. John O’Reardon is a psychiatrist with the University of Pennsylvania. He is the principal investigator for the DBS study, and has worked extensively on other new approaches to the treatment of depression, such as Vagus Nerve stimulaton and TMS, transcranial magnetic stimulation. He spoke to Maiken Scott the day of Tara’s surgery, and described how DBS works: Listen: [audio:090505msDBS.mp3]

    Story: Testing a new approach to treating severe depression Maiken Scott – May 4, 2009 A study at the University of Pennsylvania is evaluating if a surgical procedure could help people who are suffering from severe depression.

    May 4th, 2009: Dr. Gordon Baltuch of the University of Pennsylvania Health System performed the six-hour surgery to implant the electrodes into Tara’s brain. Before the surgery, he explained the procedure: Listen: [audio:090505msBaltuch.mp3]

    May 4th, 2009 Tara arrived at 6 AM at Pennsylvania Hospital for brain surgery. During the procedure, electrodes will be implanted deep into her brain, in hope to stimulate areas that are not functioning correctly. Maiken Scott spoke with her and her mother before the surgery: Listen: [audio:090504mstarapreop.mp3]  

    May 1st, 2009 Tara came to the WHYY studios before undergoing a series of blood tests at Pennsylvania Hospital. She talked to Maiken Scott about her history of depression, and what her life is like living with this disorder. Listen: [audio:090504mstarahistory.mp3]

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