Brain Implants and Biofeedback are Big Money, But Ignore Social Causes of Distress

Targeted treatments are a consumerist way to address suffering.

Art by the author

The most popular psych story last week was about a woman named Sarah who found relief from a device implanted in her brain that sent an electrical pulse every time she had an irrational thought. It was supposed to be a breakthrough, but I couldn’t read about it without sci-fi dystopias playing in my head.

Granted, on an individual level, this implant — technically called Deep Brain Stimulation — could be helpful. All the articles I read said she had been suffering for years. While none explained anything about her life or her context whatsoever, they did quote her saying she was relieved.

Ars Technica’s take says:

“When it detects neural activity associated with irrational thoughts, which previously triggered depressive obsessions, its electrodes deliver a short, corrective electric pulse and ‘poof… the cycle stops,’ as Sarah put it.”

The researchers have hope that this could help alleviate an epidemic of depression, which is the leading cause of disability worldwide, currently afflicting one in five 15–24 year olds.

The brain implant is specifically for people with treatment-resistant depression, which usually means they don’t respond to anti-depressants. But this isn’t exactly rare, if you look at the data — in his book Sedated, James Davies writes that, in other areas of medicine, pharmaceutical advances resulted in better outcomes throughout the population over time, as you would expect if the medicines worked. But this hasn’t been the case for psychiatry.

Mental illnesses have actually gotten worse alongside the development and widespread prescribing of psychiatric drugs. Robert Whitaker wrote an entire book about this, finding that in any country where prescribing went up, the rate of people on disability for mental illnesses went up with it.

If the drugs treat depression, why haven’t rates of depression gone down? Why do studies actually show worse outcomes — more depressive episodes, for longer — when people stay on antidepressants long-term? And why are we still sinking money into changing individual brains instead of looking at ways to…