Light at the end of a long, dark night
Once, Becky Steffens felt so ashamed of her depression that she didn’t tell anybody. Not even her parents.
Now, the special education teacher took time off from that beloved job to share her painful journey.
Maybe it’ll help somebody else.
Becky, after more than 25 years of searching in vain for help, found it in cutting edge medicine from Dr. Cristina Sophia Albott, an M Health Fairview and University of Minnesota Medical School faculty psychiatrist.
“She’s kind of a superstar,” Dr. Albott says of Becky who she sees in the Interventional Psychiatry Program at the University of Minnesota Physicians St. Louis Park Clinic.
Science takes time. Especially with a complex organ like the brain.
Just about all of us have had bouts with the blues, but the darkness Becky stared down is unfathomable. “Sticky,” too.
That’s the word Dr. Albott uses to describe the unshakeable thoughts that take her patients to desperate places.
Places, unfortunately, where they often feel that life isn’t worth living.
Becky’s saving grace might be that she’s “high-functioning,” able to forge ahead, no matter how bad she feels – she was even named her high school class’s Valedictorian.
With that energy, Becky fought back, seeking all kinds of help over the years, including outpatient and inpatient therapy as well as some 50 different medications.
Nothing really worked until Becky navigated the wait list to secure an appointment with Dr. Albott who specializes in cases like hers – treatment resistant depression.
“The truth is there aren’t many clinics that do what we do,” Dr. Albott says. “I wish there were more of us.”
“Being at this clinic has meant a lot to me.”
Dr. Albott has several promising new tools to offer patients whose depression, like Becky’s, hasn’t responded to traditional treatments.
Each, in its own way, is designed to stimulate areas in the brain that are believed to be the source of the dysfunction.
One tool, a vagus nerve stimulator (VNS), features an implantable device that targets mood control. Another, transcranial magnetic stimulation (TMS), attempts to break the cycle of depression.
“Brain stimulation is really, at the end of the day, the future of psychiatry,” Dr. Albott says. “I mean, if you can treat the organ that is dysfunctional, without all the systemic side effects, who wouldn’t want that?”
“What is it about trauma that changes us?”
Dr. Albott, like many U of M professors, is a researcher as well as a clinician.
That means she gets the best of both worlds: Working one-on-one with patients and developing even more effective treatments for them.
One area Dr. Albott studies is post-traumatic stress disorder (PTSD) and its outsized role in triggering treatment resistant depression.
Another is the use of the drug ketamine to stimulate, perhaps even reset, brain circuitry damaged by trauma or depression.
Becky is a fan of how research can help: “I can come in and have really high suicidal ideation and after treatment, that’s completely gone.”
I’m learning how not to be depressed.
Becky hasn’t had a bout with depression since July of 2023.
She and Dr. Albott continue to refine her treatment, both in terms of which medications are needed and which are not and how much of each is optimal.
Talk therapy is important, too. Dr. Albott helps Becky troubleshoot traumatic life events that can trigger a flare-up.
Becky looks forward to the day when she can finally add a new word to her diagnosis: Remission.
“I want people to know that there’s hope,” Becky says. “Maybe you can’t hold hope for yourself, but there are people who can hold it for you.”
She adds: “Hold on.”
Exploring the benefits of clinical research
C. Sophia Albott, MD, MA discusses clinical research and its impact on depression.
PUTTING DISCOVERY INTO PRACTICE
M Physicians are an extension of the University of Minnesota Medical School. As Medical School faculty, they are always looking for new and better ways to treat patients, whether in the laboratory or the clinic. And through clinical trials, cutting-edge therapies are sometimes available to patients when the standard of care is no longer enough.
What is Academic Medicine?
Most medicine is practiced within what is called “the standard of care.” Simply put, “standard of care” is the treatment that is commonly accepted for treating illness. This is a good thing! It means that patients receive treatments that are known to be generally effective and reliable.
The goal of academic medicine is to treat patients while looking for better therapies. It takes the toughest problems from the clinic and looks for solutions in our research. Many of our physicians — leaders in their fields — are also scientists.
When a patient faces an illness that requires treatment that exceeds the standard of care, academic medicine can provide access to newer therapies.
Psychiatrist, M Health Fairview and University of Minnesota Physicians
