The 10% of the people worldwide who will experience some form of depression in their lives are very fortunate that there are many treatment options available today —but not everyone responds to them in the same way. Online depression support communities, medications, and psychotherapy just don’t cut it for some people.
Now, a fascinating form of treatment is gaining ground and may change the way we view the treatment of mental disorders.
A Short Aside on the Nature of Depression
Many people will wonder why researchers are looking into advanced and frankly, risky, treatments to help alleviate the symptoms of depression—so before getting into the details, I’d like to take a moment to fill you in on some lesser-known facts about the disorder.
First of all, there are many degrees of depression. Some people experience it in response to traumatic events and feel down for a few days. Some people deal with occasional bouts that affect them for a couple weeks or a month.
But major depression, which is what we’re talking about here, is different. It’s persistent, and can last many years, or even throughout an entire lifetime. It’s characterized by sadness, low self-esteem, loss of interest in activities that are usually enjoyable, and can disrupt many parts of a person’s day-to-day life. It may also include thoughts of suicide or self-harm. In serious cases, people may not be able to socialize, work, or even care for themselves.
And while antidepressant medications are very often effective in treating these symptoms, some people experience treatment-resistant depression in which no treatments seem to help. The technology discussed in this article is important because it can help people with this type of depression—severely disruptive and resistant to traditional treatments.
If you want more information about depression, you can start by checking out these five websites for depression and bipolar support.
One of the most fascinating treatments for depression that’s currently being tested is deep-brain stimulation, in which a light electrical current is applied to specific parts of the brain that are involved in mood regulation. This stimulation, in many cases, results in a profound antidepressant effect, allowing some people who have lived with debilitating depression to continue on with their lives.
Major depression isn’t the only condition for which deep-brain stimulation has been prescribed; it’s also used in the treatment of Parkinson’s symptoms, Tourette’s, epilepsy, and chronic pain, with varying degrees of success.
The mechanical and electrical principles behind this stimulation are actually quite simple; small electrodes are inserted into the brain through holes drilled into the skull. These electrodes are controlled by a small device, much like a pacemaker, that’s implanted elsewhere in the patient’s body, such as below the skin on the chest. This device generates the impulses that are sent through wires to the electrodes.
The device can also be used to turn the electric current on and off. Because the system can be disrupted by magnetic fields, allowing the patient to turn the current off and then back on can be convenient.
Interestingly, scientists still don’t fully understand the way in which deep-brain stimulation works and how it causes the effects that it does.
Deep-Brain Stimulation for Depression
Despite a number of controversies (which we’ll discuss in a moment), and no matter how little doctors understand about the mechanisms behind deep-brain stimulation, it’s clear that, at least in some cases, it works wonders. In an interview with Huffington Post earlier this year, Brandy Ellis stated that the stimulator implant changed her life:
Now that I have persevered through the episode, and had the surgery, I get to build a new ‘me.’ I’m changing my behaviors beliefs, thoughts, and feelings. I am creating a new life based on what I value, because my goal has been to never return to the life I had before. I get the opportunity to implement all the tools from therapy that I have learned, with the hope that they will help me be more effective. Now that I have my implant, life is all possibilities.
And there are others who have said similar things. You can read a great first-person account of the pains of depression and the hope that an effective deep-brain stimulator brought to Liss Murphy, a Boston woman, at WBUR’s CommonHealth. And there are a number of others.
The evidence goes beyond first-person accounts. A German team trialed a deep-brain stimulation depression treatment last year and found that six of the seven patients’ symptoms improved “considerably and rapidly.” This particular study used electrical currents to target the brain’s reward system. A number of other studies have come up with similar findings.
But not everyone is convinced.
A number of people are skeptical of the efficacy of these treatments, and with good reason. First of all, while some studies have shown solid improvements in participants, a few have shown that the treatments are only as effective as more standard, less-invasive treatments. And if a treatment as risky, complicated, and expensive as implanting electrodes in the brain isn’t any more effective than prescribing medications, there’s no reason to continue studying it.
Let’s clear up what “risky” means. Any procedure that involves drilling holes in the skull is going to be risky. While neurosurgeons are really great at what they do, and take every necessary precaution, there are always going to be some risks, like infections caused by the implanted hardware, or bleeding on the brain. For the most part, the operations are safe . . . but the risk adds another factor to why some people are skeptical of the treatment.
Beyond the cost/benefit analysis of the procedure, there’s the question of whether or not we’ve studied it enough. Many of the studies have only used a handful of participants, and some of them weren’t performed in a properly scientific, controlled manner with placebos and double blinds.
A Promising Technology
With all of the conflicting positive and negative results, it’s difficult to tell what the future holds for this sort of treatment. That being said, medical technology is advancing all the time, and with better targeting and analytical abilities, it seems likely that the efficacy of this treatment is likely to increase.
In addition to that, there’s the argument that even if science can’t prove it to be effective, it’s possible that it still works for many people, and shouldn’t be discounted (take acupuncture for example; I have personal experience with some of the amazing effects that it has, but the scientific jury is still out).
Needless to say, with the number of people suffering from major depression to the point where they can’t work or socialize, interest in treatments like this one remains high—as it does with other experimental treatments, like optogenetics, the application of light to genetically modified cells in the brain.
What do you think? Should we be messing around with how the brain functions by applying electricity? Would you be interested in undergoing a treatment like this to treat severe depression? Share your thoughts in the comments below.
Image credits: Hellerhoff via Wikimedia Commons, Woman feeling so along via Shutterstock, Nerve Stimulator, X-Ray via Shutterstock, Fall lifestyle concept, harmony freedom. Casual young woman girl relaxing in autumnal park sitting on bench with book having fun, closed eyes. Golden colorful leaves background via Shutterstock.