Electroconvulsive therapy (ECT), known to some as “shock treatment,” is used to treat severely depressed or suicidal people who don’t respond to other forms of treatment or can’t take antidepressants. A small electric current is delivered to the patient’s brain while he is sedated under general anesthesia. The current, which lasts for about 40 seconds, causes seizure activity in the brain and typically brings immediate relief. Experts aren’t sure why it works. Some people may suffer from temporary confusion and memory loss. ECT is usually administered once every two to five days, for a total of six to 12 sessions.
Transcranial Magnetic Stimulation
A newer type of treatment, transcranial magnetic stimulation (TMS) uses magnetic fields to stimulate cells in the brain. Like ECT, it is used when other forms of treatment, such as medication and therapy, don’t work. A large electromagnetic coil placed against the scalp delivers painless electric currents to the brain to stimulate areas associated with mood. Because TMS is so new, researchers are still trying to determine the best areas of the brain to target and the most effective dose of electric current. Its long-term effects are still largely unknown.
Deep Brain Stimulation
Originally used as a treatment for Parkinson’s disease, deep brain stimulation (DBS) is still considered experimental in its use for depression. With DBS, two electrodes are surgically implanted into an area of the brain that is overactive in people with depression. The electrodes provide continual electric stimulation via a generator that is embedded in the chest. Researchers believe the electric pulses reset the brain and help it to function normally.
Vagus Nerve Stimulation (or Vagal Nerve Stimulation)
Like deep brain stimulation, vagus nerve stimulation (VNS) is a type of brain-stimulating therapy that uses an implanted device to send electric currents to the brain. Instead of putting a set of electrodes in the brain, one electrode is embedded just underneath the skin along the vagus nerve in the neck. The vagus nerve transmits messages from the brain to some major organs, such as the heart, lungs, and intestines, as well as to select parts of the brain. Stimulating this nerve appears to alter the levels of neurotransmitters (brain chemicals) associated with mood regulation. As with DBS, a pulse generator implanted in the chest controls the electrode. VNS is an experimental treatment and the long-term side effects of its use are currently unknown. It is only used in cases of severe or chronic depression when other treatments fail to work.