On the Front Lines in the Battle Against Depression
Eric Tirrell ’13 (right) with clinic director Dr. Linda Carpenter (left) and interventional psychiatry technician Wenricka Griffith ’22 (in chair), simulates a neuronavigated brain stimulation procedure in the TMS Clinic/Neuromodulation Research Facility at Butler Hospital.
As research manager for Butler Hospital’s Center for Neuromodulation, URI psychology grad Eric Tirrell ’13 helps scientists and patients make breakthroughs.
Imagine being in the grips of a condition that crushes all hope and smothers your personality under the weight of its all-consuming despair. This is major depression—a condition that affects more than 20 million Americans.
Now imagine that after years of therapy and a dozen failed medications, you learn of a revolutionary treatment called transcranial magnetic stimulation (TMS) that has helped nearly 60 percent of patients who, like you, hadn’t responded to other treatments.
Since graduating from URI with a degree in psychology, Eric Tirrell ’13 has worked to expand the use of this remarkable treatment. As manager of research operations in Butler Hospital’s Center of Biomedical Research Excellence (COBRE) Center for Neuromodulation in Providence, he coordinates dozens of cutting-edge research projects headed by experts from URI, Brown, and Rhode Island, Bradley, Miriam, and Butler hospitals. He says the most gratifying part of his job comes with his role as clinical supervisor for the hospital’s TMS program, where he witnesses remarkable transformations in patients, many of whom were on the verge of giving up.
“At the beginning of treatment, they sit in that chair crying because they feel so anxious and hopeless,” he says. “Then, six weeks later, that same patient sits in that chair crying with relief.”
The chair Tirrell refers to is the dentist-like lounger where TMS treatments take place. It’s a remarkably noninvasive procedure. There are no incisions, no injections, no medications, and no anesthesia—just a magnetic device the size of a hand that’s placed just above the patient’s forehead to deliver a series of rapid magnetic pulses. The pulses stimulate electrical activity in the prefrontal cortex of the brain, the region associated with mood regulation. The theory is that depression occurs when the electrical activity in this region becomes dysregulated, causing mood to deteriorate.
“The way I explain it is that TMS strengthens the brain the same way several weeks of physical therapy strengthens muscles.”Eric Tirrell ’13
There are none of the side effects associated with antidepressants, such as anxiety, drowsiness, insomnia, nausea, weight gain, or sexual dysfunction—just a mildly annoying feeling as though someone is tapping their finger on your forehead.
Through the course of 40 half-hour treatments, which take place over six weeks, these pulses stimulate electrical activity in the brain, thus strengthening brain circuitry.
“The way I explain it is that TMS strengthens the brain the same way several weeks of physical therapy strengthens muscles,” says Tirrell.
Like many first-year college students, Tirrell entered URI unsure what he wanted to study. He took courses in a variety of subjects, including business and landscape architecture; none of them really clicked. But when he took Psychology 101, the tumblers fell into place. He was fascinated by courses in abnormal psychology, psychopharmacology, and social psychology, and he knew he had found his path.
After graduation, Tirrell took a job in Butler Hospital’s TMS Clinic, a setting where he has thrived over the past nine years.
“Eric is an integral member of our community, and I personally rely on him for so much, as do our patients,” says Dr. Linda Carpenter, director of Butler’s TMS Clinic and its neuromodulation research facility. “He’s the only person who knows how to do everything. He functions as clinician, technician, administrator, and research manager all rolled into one. He’s a can-do person with incredible leadership skills, and he’s always looking for a way to improve our services.”
In his role at Butler’s COBRE research program, Tirrell has contributed to more than 60 research projects. One of the newest projects is co-led by Nicole Weiss, URI associate professor of psychology and an expert in post-traumatic stress disorder (PTSD). The study will determine whether cranial electrical stimulation, a treatment similar to TMS, can be used to prevent PTSD in firefighters.
“This is important because firefighters are chronically exposed to trauma, causing one in three firefighters to suffer from PTSD,” says Weiss. “Our goal is to find a way to prevent PTSD, rather than waiting for the condition to develop and treating it after the fact. Nothing like this currently exists.”
Weiss will be using a portable device the size of a cell phone that study participants can use at home to deliver a low-level electrical current. Like TMS, the goal is to stimulate brain activity to strengthen the brain’s defenses against PTSD.
Other current studies focus on finding ways to predict the recurrence of depression and studying alternative treatments, such as psychedelics like ketamine.
Tirrell is fascinated by the science, but it’s the impact on people’s lives that gives Tirrell the greatest job satisfaction.
“Some of the patients’ stories are heartbreaking. I remember one 16-year-old, straight-A student. He was suicidal and horribly depressed. He had tried more medications than the number of years he’d been alive. It’s incredibly sad up front, but great to see them progress and reclaim their lives.”
—Bill Ibelle
PHOTOS: NORA LEWIS