Healthy Mind Tricks: The Potential of VR in the Treatment of Mental Illness

      In an America where 18.5% of adults and 21.4% of youths are affected by mental illness in a given year, the average length of time between the onset of symptoms and the receipt of effective treatment is 8-10 years.  

    The reasons for this delay are significant, and not easily remedied: costs for regular therapy visits are prohibitively expensive for many people, and the societal stigma associated with seeking mental health assistance is extreme.  Medications prescribed for mental illness take weeks to work, vary wildly in efficacy from person to person, and many have terrible, debilitating side effects.  

    The need for an evolution in mental health treatment is quite evident, and an obvious place to look for solutions is in the rapidly-evolving field of technology.  Virtual Reality is one of these rapidly-evolving technologies, and with the release of the Oculus Rift, Samsung VR, and others, we are finally approaching a point where widespread adoption of VR technology seems likely.  This imminence presents the question:  Can Virtual Reality provide a viable alternative treatment option for the millions of Americans (and countless worldwide) who suffer from untreated mental illness?

    Upon a bit of internet research, it turns out that VR Therapy as an experimental treatment option has been in development for several decades, particularly in the context of treating one of the more widespread mental illnesses in America, Post-Traumatic Stress Disorder (PTSD), which affects an estimated 24.4 million people a year.

    The military is at the forefront of this research for a couple reasons.  For one, the military is one of the few organizations that has the budget available for VR equipment, which has been prohibitively expensive since its advent in the 90s.  Also, PTSD is common amongst soldiers, traumatized by the horrors of war.

    Exposure Therapy, a common method for treating PTSD and many phobias, is the practice of exposing patients directly to their traumatic memories in order to gradually desensitize their nervous systems to those memories.  If, for instance, the patient suffers from horrific memories of war, Exposure Therapy seeks to immerse the patient back in that experience repeatedly until he or she is no longer sensitive to the memories.  Talk therapy in conjunction with psychotropic drugs is commonly used to attempt to place the patient back into the memory, but VR, in conjunction with drugs or by itself (depending on the patient) has a high potential to be a much more effective method.

    Dr. Albert Rizzo is director of Medical Virtual Reality at the Institute for Creative Technology at the University of Southern California, where he has developed a VR Exposure Therapy application called “Bravemind,” which he sells to institutions around the world such as governments and universities.  His system costs $17,000 each, an obvious stumbling block for many smaller institutions.  Bravemind is powerful, though, using multiple components to deliver stimuli to a patient’s various senses.  In addition to an interactive visual/auditory VR environment, the simulation includes a vibrotactile component that simulates the feel of explosions & gunfire, and a scent emitter that can create smells such as diesel fuel & gunpowder at specific moments.  This combined with the immersive visual & auditory experience of a VR war simulation has proven, based on a recent study published by the American Journal of Psychiatry, to be an effective method for treating PTSD, often more effective than psychotropic drugs and talk therapy combined.

    Exposure therapy is not the only PTSD treatment method effectively administered through VR.  A company called Beyond Care is testing a VR system that uses a principle called “eye movement desensitization reprocessing” (EMDR) to treat PTSD through VR.  EMDR involves having a patient follow moving objects with their eyes while recalling traumatic memories.  Over time and repetition, the dual task of intentional eye movement plus traumatic memory recall overworks the working memory, causing the traumatic memory to become less vivid and impactful.  Beyond Care is currently partnered with a Dutch university to test the treatment virtually over the internet to see whether this treatment can be effectively administered by the patient in his or her own home.  If effective, this type of treatment could be very promising for patients who don’t have the money or time for long-term repeated visits to psychotherapists.  Even if the treatment is semi-supervised by a psychotherapist, cutting down from weekly appointments to monthly appointments could be the difference between affordability and continued suffering.

    While less thoroughly tested than normal VR exposure therapy, the advantage of EMDR over more specific exposure simulations is that the program doesn’t have to be designed for a specific trauma.  Military personnel are not the only sufferers of PTSD— victims of rape, sexual trauma, social trauma and many others are also prone to PTSD, and EMDR can work for all of those PTSD patients via the same program, rather than designing a specific “rape simulation,” for instance, to expose the rape victim to her or his trauma.  

    While the bulk of VR Therapy research has related to PTSD (due to the military being one of the few organizations that can afford to study it), there are other mental illnesses, particularly Phobias and Anxiety disorders, now being targeted for VR treatment.

   Debilitating anxiety & specific phobia combines to affect about 60 million people in the United States each year.  A recent meta-analysis of 14 clinical trials showed that VR exposure therapy was as effective in treating phobias as real-life exposure therapy.  This is particularly of note because many patients’ fears, such as fear of flying or fear of heights, are not easily or economically available to experience in real life repeatedly for the sake of therapy.  Several companies have developed systems to combat fear of flying, fear of heights, fear of storms, and fear of public speaking, including The Virtual Reality Medical Center, Virtually Better, CleVR and VirtualRET.  These companies are all competing to develop the most immersive, effective systems possible, and the competition is only speeding up the research, development, and evolution of the design & technology of VR therapy.       

    So if it’s been around for decades, and proven to be effective, why hasn’t VR therapy become a standard option for those seeking treatment?  The answer throughout the decades has been that prohibitively high costs & not-quite-there-yet technology have prevented mainstream adoption by both consumers & medical professionals alike.

    However, finally in 2016, the imminent release of new hardware like the Oculus Rift and the Samsung Gear VR seem to signify that VR technology has finally found a solution to mass-consumer adoption: Costs are approaching the point where they are low enough to allow the average person to afford their own headsets, and the technology is becoming immersive enough to make users nearly forget they are in a world that’s only virtual.

    This presents the opportunity for VR therapy to finally become a mainstream option for everybody, including people who cannot afford regular visits to expensive mental health professionals on a regular basis.

    Virtual Reality might not be a “golden bullet” for mental illness, but it does provide an appealing and potentially effective alternative to expensive therapists & debilitating drugs.  The opportunity to immerse yourself in treatment from the privacy of your home, on your own time, without paying hundreds of dollars every week will be worth a try, especially for long-suffering people who already own VR headsets, the number of which is about to rise significantly with the aforementioned release of several new, affordable, cutting-edge headsets this year.  The more people that try VR as a treatment option, the more data will become available, paving the way for mainstream acceptance of VR-treatment, and potentially cutting down the time that the average person takes to seek treatment or find effective treatment from 8-10 years to immediately.

SOURCES

http://techcrunch.com/2016/01/06/virtual-reality-therapy-treating-the-global-mental-health-crisis/

http://www.wired.com/2015/03/virtual-reality-wont-just-amuse-will-heal-millions/

https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers

https://www.ncbi.nlm.nih.gov/pubmed/24743802

http://www.ptsdunited.org/ptsd-statistics-2/

 

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