When treatments such as therapy and medication altogether don’t provide the results to relieve depression symptoms, a psychologist has other options available under his sleeves.
Brain stimulation therapies are the next stage of the treatment. The treatment involves stimulating or touching the brain directly using electricity, magnets, or implants.
Electroconvulsive Therapy (ECT)
The procedure of ECT includes passing controlled electric current through the patient’s brains. During this procedure, the patient will be under the influence of general anaesthesia. This will allow controlled seizure that affects neurons and chemicals in the brain.
ECT is suggested to patients with severe depression and depression with psychosis that doesn’t respond to any medication. Sometimes ECT is recommended to patients who have resistant bipolar disorder.
ECT was once called electroshock therapy still owns several negative associations. In fact, when first introduced in the 1940s, the method was very primitive. Today everything has changed.
During this procedure, the patient is asleep and wakes up 5-10 minutes after the procedure is completed. The patient can get back to his normal daily activities within an hour.
Four to six ECT treatment needs to be carried out to see any improvement in the patient.
- Physical effects: headaches, muscle pain, and nausea
- Confusion after treatment usually lasts from a few minutes to hours.
- Memory loss: Memory loss may appear to patients ranging from forgetting a conversation right before or after the treatment, forgetting incidents from weeks or months before or after treatment, and the last case is very rare, i.e. forgetting from years before.
Transcranial Magnetic Stimulation (TMS)
The procedure of TMS includes creating a magnetic field to stimulate nerve cells in the patient’s brain. This nerve cell stimulation in the brain will help with the improvement in the depression symptoms. During this procedure, a large electromagnetic coil is placed over the patient’s forehead and short pulses placed in the brain area, which controls the patient’s mood. Unlike ECT, this procedure does not require any use of anaesthesia as the treatment procedure is carried out when the patient is awake.
The standard procedure with TMS treatment takes up to 40 minutes. However, the consulting psychologist will decide how many TMS does the patient require on a weekly basis.
The TMS treatment is not recommended for people who experience depression with psychosis or bipolar disorder or facing high suicidal tendency. Treatment is also to avoid people who have a pacemaker or any metal objects in their head.
- Contraction of muscles or tingling effect in our jaw or face
- Seizure, for people who has a seizure history
Note: The most commonly and widely used brain stimulation therapies are ECT and TMS. There are two more options available for brain stimulation therapies; unfortunately, their effectiveness remains unclear as widely studies on them weren’t conducted.
Vagus Nerve Stimulation (VNS)
The procedure of VNS treatment uses a pulse generator. The pulse generator is placed in the upper left side of the chest. This stimulates the vagus nerve; it carries messages to the brain that controls the mood and sleep with the help of electrical impulses.
This procedure is used for treating depression and other medical conditions such as epilepsy.
The VNS treatment has been approved by the FDA for heard-to-treat depression if the depression hasn’t been improved with medication or ECT. In fact, treatment with VNS is controversial and thus rarely recommended.
- change in voice
- sore throat or cough
- difficulty while swallowing
- neck pain
- discomfort in the area where the pulse generator is placed
- difficulty breathing while exercising
Deep Brain Stimulation (DBS)
DBS was developed initially to reduce tremors from Parkinson’s disease. The FDA approved the DBS treatment procedure for the obsessive-compulsive disorder (OCD). At present DBS is studied for treating Tourette’s syndrome and major depression. The treatment with DBS for mental health is considered experimental, and its effectiveness and safety is unknown.
The procedure of DBS involves two electrodes placed directly in our brain with the help of surgery and a pulse generation placed on the patient’s chest.
- mood swings
- breathing problems
- speech problems
- bleeding in the brain
There are several side effects which take place due to the surgery or the stimulation. With several months of DBS treatment, the patient getting adjusted to the electrodes may help.