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Treatment Resistant Depression

Chronic, unresponsive depression interferes with the sufferer's life every moment of every day. When antidepressants and off-label usage of other drugs fail, it is devastating for the patient. To know that each day brings suffering and every morning brings dread is a life not many people want to live. However, new procedures exist that may change this line of thinking. Some are still in experimental phases but they may change the treatment of depression as many now know it.

  1. Electroconvulsive Therapy (ECT)

    • Electroconvulsive therapy (ECT) occurs when electrical currents are passed directly through the brain, causing a seizure. ECT is remembered for its brutal application to mental patients more than 70 years ago when high doses of electricity were used on subjects for days on end. The electrical current sparks changes in brain function, mood and reactions. However, the view of ECT is still split down the middle; some report that it helps cure drug-resistant depression while others see it as simply a barbaric destruction of brain functioning. ECT is reserved for use in people with severe depression who have a high risk of fatality.

    Vagus Nerve Stimulation (VNS)

    • In 2005, the Food and Drug Administration approved vagus nerve stimulation (VNS) for treatment of chronic or drug-resistance depression. The vagus nerve is a major communication between vital organs to the brain. A thin, flexible pulse generator is implanted into the chest, with the wires connected to the vagus nerve. The pulse generator then sends pulses to the wire and vagus nerve, which then are passed to areas of the brain that regulate mood. According to the VNS website (vnstherapy.com), the procedure is for adults starting at the age of 18 who have experienced chronic depression that cannot be treated, even with numerous antidepressants prescribed. The website also says that the VNS improves quality of life, relationships and the ability to function and gives patients more energy. It also claims that VNS therapy approves with time.

    Transcranial Magnetic Stimulation (TMS)

    • Transcranial magnetic stimulation (TMS) is a highly experimental method used to treat depression using magnetic fields to stimulate nerve cells within the brain. It is to be used when all other options fail. Large coils are held over the appropriate section of the brain to induce an electrical current in the brain. Mounted coils and head rests may play a role in creating better results in a subject's depression. There are few reports available on TMS currently.

    Deep Brain Stimulation

    • Deep brain stimulation is another highly experimental technique used to cure depression. A wire with four electrodes is introduced to the affected area of the brain. It connects to a battery-run generator implanted by the collarbone, which allows the user to turn it on or off. The surgery is done while the patient is awake to ensure the correct region of the brain is targeted. Deep brain stimulation is supposed to help treat depression by sending electrical pulses through the wire to the part of the brain the electrodes are attached to and, in theory, possibly correcting malfunctions in the brain that augment depression. In its July 31, 2008, article "Deep Brain Stimulation," the Mayo Clinic regards this treatment as highly experimental in regards to depression as it is usually used to help stabilize shaking from Parkinson's disease.

    Conclusion

    • Some of the new techniques look and sound promising. Hopefully, over the next few years, they will be fine-tuned and tested and able to help someone in desperate need who is suffering in the dark and bleak world of depression.

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